Drug Cards PDF

Drug
Med Cards
Drug Med Cards
Table of Contents
1. Anti-
Viral .............................................................................
.............................................................. 5
2.
Benzodiazepenes ...................................................................
........................................................... 6
3.
Diuretics .........................................................................
................................................................... 8
4. Antiseizure
Meds ..............................................................................
................................................ 9
5. Vitamins and
Minerals ..........................................................................
.......................................... 13
6.
Steroid ...........................................................................
.................................................................. 14
7.
Opiod..............................................................................
................................................................. 15
8. Opiod
Antagonists........................................................................
................................................... 17
9.
NSAIDS ............................................................................
................................................................ 18
10. Analgesic,
Antipyretic .......................................................................
.............................................. 19
11.
Anticholinergic ...................................................................
............................................................. 20
12.
Bronchodilator ....................................................................
............................................................ 21
13. Thyroid Hormone
Replacement .......................................................................
............................... 22
14. Alpha Adronergic Receptor
Antagonist ........................................................................
.................. 23
15. Antiparkinson (Cholinergic Receptor
Antagonist.........................................................................
... 24
16. Fluid and
Electrolytes ......................................................................
................................................ 26
17.
Antibiotics .......................................................................
................................................................ 28
18. Cholesterol Lowering
Agents ............................................................................
.............................. 32
19. Laxatives/ Stool
Softeners..........................................................................
..................................... 34
20. Anti-
Diarrheal..........................................................................
........................................................ 36
21. Beta-
Blockers ..........................................................................
........................................................ 37
22.
Nitrates ..........................................................................
................................................................. 39
23. ACE-
Inhibitors ........................................................................
......................................................... 40
24. Calcium Channel
Blockers ..........................................................................
..................................... 41
25. Central Acting
Antihypertensive ..................................................................
................................... 42
26.
Antihypertensives .................................................................
.......................................................... 43
27.
Antipsychotics ....................................................................
............................................................. 44
28. Anti-
Coagulants ........................................................................
....................................................... 50
29.
Antiplatelets .....................................................................
............................................................... 51
30. Proton Pump
Inhibitor .........................................................................
........................................... 52
31. H2- Receptor
Antagonist ........................................................................
......................................... 53
32. Cerebral
Stimulant .........................................................................
................................................. 54
33.
Antihistamines ....................................................................
............................................................ 55
34.
Antidiabetic ......................................................................
............................................................... 57
35.
Antihypoglycemic ..................................................................
.......................................................... 60
36. Anti-
fungal.............................................................................
.......................................................... 61
37. Eye
Drops .............................................................................
........................................................... 62
38.
Antidepressant ....................................................................
............................................................ 63
39. Tricyclic
Antidepressants ...................................................................
............................................. 65
40. Selective Serotonin Reuptake Inhibitor
(SSRI) ............................................................................
.... 67
41. Monoamine Oxidase Inhibitors
(MAOIs) ...........................................................................
............. 69
42. Anti-
Emetic.............................................................................
......................................................... 70
43.
Antituberculosis ..................................................................
............................................................ 71
44. Substance Abuse
Deterrent .........................................................................
................................... 72
45. Bone Metabolism
Regulatory ........................................................................
................................. 73
46. Bacterial Collagenase
Enzyme.............................................................................
............................ 74
Bibliography ......................................................................
.......................................................................... 75
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Drug Med Cards
With over 8 years in the medical field, Mike

Linares has worked both out in the
field on an Ambulance in the dangerous streets
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Mike Linares
Student Nurse Mentor & Certified EKG
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HOW THIS WHOLE THING CAME TO BE...

Before Helping Multiple Successful Nursing Students
Excel I Was The "Drone" Nursing Student Working Too
Hard & Eventually I FAILED OUT of Nursing School.
Before Helping Hundreds of Struggling Nursing Students Reach Graduation Day &
Before Becoming a
Student Nurse Mentor & Certified EKG Instructor, I Myself Was A Struggling "At
Risk" Student Nurse
Drowning In My Books & Lost In Clinical.
I was that struggling student working full time in the Emergency Room at one of
those
MEGA hospitals in Orange, California. I worked as an EMT aka a "medic" for 8 years
prior to failing out. I knew how to take care patients, I knew the basics of the
ABCs of
basic life support, I knew how to take vital signs and how to fix minor injuries. I
thought I
had enough experience to skate right through nursing school, I remember thinking
"how
hard can it be" right?
After two semesters, I FAILED out of the Program.
I felt defeated, depressed and like a loser. It was one of the lowest points of my
life.
Sitting in my room practically bawling my eyes out, I remember quotes my mom and
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&
" Failing is Not a Bad Thing, As long as learn, become better, and NEVER EVER QUIT"
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Drug Med Cards
My Clinial FAILURE form had bold red letters

stating:
LACK In Prepared
LACK Organizational Skills
LACK Critical Thinking with Nursing Process
Ending with:
"able to return next semester contingent upon
demonstrating INCREASED
COMPETANCIES in these core areas."
"NEVER GIVE UP!!" my mom & dad used to tell

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School!
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In a systematic way to put all the "core competencies" of nursing school that
instructors look for to pass
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fluff and getting down to
the nitty critty making it easier.
The Goal Was To Make A Simple System...

And the best part is it was really helping myself and other students in my class
pass their tests when I would
share with them my strategies and systems to help them pass their tests without
having to memorize
everything in the book!
This is where my mentoring for student nurses began.

That's when something clicked and everything changed for me.
It was like I had an Ah - HA moment!
At that moment I realized there are better, more predictable, and more low cost
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books that claimed to help but really just confuse me more.
I needed simplicity!!!
Within the next six months I had created over 27 different student help systems,
strategies and tactics
that produced better results for me - some better than others.
Then over the next few semesters I tracked, tested, and tweaked each system until
my students were
passing with a 82% or better on each and every test, 2 students being out of School
for over 25 years &
coming back to score 94% on their EKG cardiac test! Truly amazing & truly making me
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mentor.
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Drug Med Cards
1. Anti-Viral
1.1. Acyclovir
(Zovirax)
Class: Antiviral
Actions: reduces viral shedding and formation of new lesions and speeds healing
time. Peak: 1.5-2hr.
Half-life: 2.5-5hr.
Indications: (IV treatment) viral encephalitis, herpes simplex, varicella-zoster
virus (shingles/chickpox);
(orally) herpes simplex, varicella-zoster virus; (topically) herpes labialis (cold
sores) and initial episodes of
herpes gentitalis
Norm. Dosage, Freq, Route, Range: PO 400mg bid Max: 800mg/day
Side Effects: headache, nausea, vomiting, diarrhea
Nursing Considerations: Monitor I&O & hydration status. Lab tests: baseline and
periodic renal function
tests
1.2. Amantadine HCl

(Symmetrel)
Class: Antiviral; Central-Acting Cholinergic Receptor Antagonist; Antiparkinson
Actions: Because Amantadine does not suppress antibody formation, it can be
administered for interim
protection in combination w/ influenza. Onset:
w/in 48hrs.
Peak: 1-4hrs
Indications: Influenza A Treatment; Influenza A Preventative; Parkinsonism;
Drug-Induced
Extrapyramidal Symptoms (EPS)
Norm. Dosage, Freq, Route, Range: PO 100mg 1-2times/day
Side Effects: dizziness, light-headedness, difficulty in concentrating, insomnia,
leukopenia
Nursing Considerations: Lab tests: pH and serum electrolytes; monitor and report
mental status changes,
nervousness, difficulty concentrating, or insomnia, loss of seizure control, S&S of
toxicity, especially in
doses over 200mg/day

Page 5 of 75
Drug Med Cards
2. Benzodiazepenes
1.3. Alprazolam
(Xanax)
Class: Anxiolytic; Sedative-Hypnotic; Benzodiazepine
Actions: A CNS depressant that appears to act at the limbic, thalamic, and
hypothalamic levels of the
CNS. Has antianxiety and sedative effects w/ addictive potential. Peak: 1-2 hr.
Halh-life: 12-15 hr.
Indications: Anxiety Disorders, Panic Attacks
Norm. Dosage, Freq, Route, Range: PO 0.25-5 mg tid Max: 4 mg/day
Side Effects: Drowsiness, sedation
Nursing Considerations: Monitor S&S of drowsiness and sedation, especially in older
adults or the
debilitated, Lab tests: CBC, urinalysis and blood chemistry studies particularly
during continuing therapy
1.4. Diazepam
(Diastat, Valium)
Class: Benzodiazepine Anticonvulsant; Anxiolytic
Actions: Long-acting benzodiazepine psychotherapeutic agent. Benzodiazepines act at
the limbic.
Thalamic, and hypothalamic regions of the CNS and produce CNS depression resulting
in sedation, and
anticonvulsant activity dependent on the dosage. Onset: PO 30-60 min Peak: PO 1-2
hr Duration: IV 15
min-1 hr PO up to 3 hr
Indications: Status Epilepticus, Muscle Spasm, Anxiety, Alcohol Withdrawal, Pre-op
Norm. Dosage, Freq, Route, Range: IV/IM 5-10 m, repeat if needed at 10-15 min
intervals up to 30 mg,
then repeat if needed q2-4hr
Side Effects: Drowsiness, fatigue, confusion, vivid dreams, headache
Nursing Considerations: Monitor for adverse reactions, Monitor for therapeutic
effectiveness-max effect
may require 1-2 week, monitor for and report promptly signs of suicidal ideation
especially in those treated
for anxiety states accompanied by depression, observe patient closely and monitor
vital signs when
diazepam is given parentally; hypotension, muscular weakness, tachycardia, and
respiratory depression
may occur, Lab tests: periodic CBC and LFTs.
1.5. Lorazepam
(Ativan)
Class: Anxioltic; Sedative-Hypnotic; Benzodiazepine
Actions: most potent of the available benzodiazepine. Effects (antianxiety,
sedative, hypnotic, and skeletal
muscle relaxant) are mediated by the inhibition neurotransmitter GABA. Action sites
are thalamic,
hypothalamic, and limbic levels of CNS. Onset: IV 1-5 min. IM 15-30 min. Peak: IM
60-9 min. PO 2 hr
Duration 12-24 hr
Indications: Antianxiety, Insomnia, Premedication, Status Epilepticus
Norm. Dosage, Freq, Route, Range: PO 2-6 mg/day in divided doses Max: 10 mg/day
Side Effects: drowsiness, sedation, dizziness, weakness
Nursing Considerations: Supervise ambulation, Lab tests: Assess CBC and LFTs
periodically
Drug Med Cards
1.6. Temazepam
(Restoril)
Class: Benzodiazepine, Anxiolytic, Sedative-Hypnotic
Actions: reduces night awakenings and early morning awakenings; increases total
sleep times, absence
of rebound effects. Onset: 30-50 min. Peak: 2-3hr. Duration: 10-12hr. Half-life: 8-
24hr
Indications: to relieve insomnia
Norm. Dosage, Freq, Route, Range: PO 7.5-30mg at bedtime Max: 30mg/night
Side Effects: drowsiness, dizziness, lethargy
Nursing Considerations: hypersensitivity, Lab tests: LFTs and kidney function tests
during long-term use,
be aware of S&S of overdose: weakness, confusion, slurred speech, ataxia, coma w/
reduced or absent
reflexes, hypertension and respiratory depression

Page 7 of 75
Drug Med Cards
3. Diuretics
1.7. Furosemide
(Lasix)
Class: Loop diruetic
Actions: Inhibits NA & Cl reabsorption, ↑ urine, ↓ edema & intravascular
volume. Onset: PO 30-60min. IV
5 min Peak: PO 60-70min IV 20-60min. Duration: 2hr.
Indications: promote urine output & decrease edema associated w/ CHF, cirrhosis of
liver & kidney
disease, decrease CHF, decrease hypertension
Norm. Dosage, Freq, Route, Range: (Edema) PO: 20-80 mg in 1 or more divided doses
Max: 600 mg/day
(Hypertension) PO: 10-40 mg/kg bid Max: 480 mg/day
Side Effects: Circulatory collapse, hypokalemia, aplastic anemia, agranulocytosis
(rare)
Nursing Considerations: check K+ levels prior to adm., monitor I&O closely, rapid
acting doses to prevent
sleep disturbance, Potassium rich foods: bananas, oranges, dried dates, etc., CBC,
serum and urine
electrolytes, CO2 BUN, Blood Sugar, Uric Acid, Urine and Blood Glucose, HbA1C in
diabetic patients w/
decompensated hepatic cirrhosis, may cause hyperglycemia
1.8. Hydrochlorothiazide
(Microzide, Oretic)
Class: Electrolytic and Water Balance; Thiazide Diuretic
Actions: Therapeutic effectiveness is measured by decrease in edema and lowering of
blood pressure.
Onset: 2hr. Peak: 4hr. Duration: 6-12hr. Half-life: 45-120min.
Indications: adjunct treatment of edema associated with CHF, hepatic cirrhosis,
renal failure, and in the
management of hypertension
Norm. Dosage, Freq, Route, Range: PO 25-100mg/day in 1-3 divided doses Max:
200mg/day
Side Effects: Hyperglycemia, hyperuricemia, hypokalemia
Nursing Considerations: Check BP, monitor I&O and check for edema, Lab tests:
baseline and periodic
determinations of serum electrolytes, blood counts, BUN, blood glucose, uric acid,
CO2, are recommended.
1.9. Spironolactone
(Aldactone)
Class: Electrolytic and water balance; Aldosterone Antagonist; Potassium-Sparing
Diuretic
Actions: A diuretic agent that promotes sodium and chloride excretion w/o
concomitant loss of potassium.
Lowers systolic and diastolic pressures in hypertensive patients. Effective in
treatment of primary
aldosteronism. Onset: gradual Peak: 2-3days; Max effect may take up to 2 weeks
Duration: 2-3 days or
longer
Indications: Edema due to CHF, Hypertension, Primary Aldosteronism, Hypokalemia
Norm. Dosage, Freq, Route, Range: PO 25-400mg/day in divided doses Max: 400mg/day
Side Effects: fluid and electrolyte imbalance, nausea, vomiting
Nursing Considerations: check BP, lab tests: monitor serum electrolytes (Na and K),
assess for signs
and symptoms of fluid and electrolyte imbalance, monitor daily I&O and check for
edema

Drug Med Cards
4. Antiseizure Meds
1.10. Carbamazepine
(Carbatrol, Tegretol, Epitol, Equetro, Mazepine)
Class: Anticonvulsant tricyclic
Actions: effective anticonvulsant for a range of seizure disorders and as an
adjuvant reduces depressive
S&S and stabilizes mood. Peak: 2-8hr. Half-life: variable due to autoinduction 25-
65hr. than 14-16he with
repeated use
Indications: Seizures; Trigeminal Neuralgia; Bipolar Disorder (Equetro)
Norm. Dosage, Freq, Route, Range: PO 200mg bid, gradually increase to
800-1200mg/day in 3-4 divided
doses Max: 1200mg/day
Side Effects: leukopenia, confusion, headache, dizziness
Nursing Considerations: Lab tests: baseline and periodic CBCs including platelets,
reticulocytes, serum
electrolytes and serum iron, LFTs, BUN and complete urinalysis, attempt a dosage
reduction after 3
months, monitor for toxicity, I&O and vital signs
1.11. Clonazepam
(Klonopin)
Class: Anticonvulsant; Benzodiazepine
Actions: Suppresses spike and wave discharge (petitmal) and decreases amplitude,
frequency, duration,
and spread of discharge in minor motor seizures. Onset: 60 min Peak: 1-2 hr
Duration up to 12 hr in adults;
6-8 hr in children
Indications: Seizures, Panic Disorders
Norm. Dosage, Freq, Route, Range: PO 1.5mg/day in 3 divided doses, increased by
0.5-1 q3days until
seizures are controlled or until intolerable adverse effects Max: 20 mg/day
Side Effects: Drowsiness, sedation, ataxia
Nursing Considerations: Monitor for signs of suicidal ideation in depressive
individuals, Lab tests:
periodic LFTs, platelet counts, blood counts, and renal function tests, Monitor for
S&S of overdose, including
somnolence, confusion, irritability, sweating, muscle and abdominal cramps,
diminished reflexes, coma.
1.12. Gabapentin
(Neurontin)
Class: Anticonvulsant; Gaba Analog
Actions: Used in conjunction with other anticonvulsants to control types of seizure
in patients with epilepsy.
Effective in controlling painful neuropathies
Indications: Seizure disorder, Past-Herpetic Neuralgia, Restless Leg Syndrome
Norm. Dosage, Freq, Route, Range: start at 300mg may slowly increase Max:
1,200mg/day
Side Effects: drowsiness, fatigue
Nursing Considerations: monitor for therapeutic effectiveness, may not occur until
several weeks
following initiation of therapy, monitor for and report dizziness, somnolence, or
other sign of CNS
depression
Page 9 of 75
Drug Med Cards
1.13. Lamotrigine
(Lamictal)
Class: Anticonvulsant
Actions: may act by inhibiting the release of glutamate and aspartate, excitatory
neurotransmitters at
voltage-sensitive sodium channels, resulting in decreased seizure activity in the
brain. Onset: 12wks. Peak:
1-4hr.
Indications: Seizures; Bipolar disorder
Norm. Dosage, Freq, Route, Range: PO start w/ 25mg daily for 2 wks, then 50mg daily
for 2 wks, then
100mg daily for 1 wk, then 200mg daily (low and slow)
Side Effects: dizziness, ataxia, somnolence, headache, nausea, diplopia, blurred
vision, Stevens-Johnson
syndrome, toxic epidermal necrolysis, rhinitis
Nursing Considerations: do not take med if skin rash develops, monitor pts. w/
bipolar disorder for
worsening of their symptoms and suicidal ideation, use protection from sunlight or
ultraviolet light until
tolerance is known
1.14. Levetiracetam
(Keppra)
Actions: The precise mechanism of antiepileptic effects is unknown. Peak: 1hr.
Indications: Partial onset Seizures; Tonic Clonic Seizures; Myoclonic Seizures
Norm. Dosage, Freq, Route, Range: PO/IV 500mg bid may increase by 500mg
bid q2wks. Max:
3,000mg/day or 1,000 mg/day ER tablet
Side Effects: Asthenia, headache, infection, somnolence, suicidal ideation
Nursing Considerations: Lab tests: periodic CBC w/ diff, Hct, and Hgb, LFTs;
monitor individuals w/ a
history of psychosis or depression for S&S of suicidal tendencies, suicidal
ideation, and suicidality
1.15. Oxcarbazepine
(Trileptal)
Actions: Anticonvulsant properties may result from blockage of voltage-sensitive
sodium channels, which
results in stabilization of hyper-excited neural membranes. Peak: steady-state
level reached in 2-3 days
Indications: Partial Seizures
Norm. Dosage, Freq, Route, Range: PO start w/ 300mg bid and increase by 600mg/day
qwk. To
2,400mg/day in 2 divided doses for monotherapy or 1,22mg/day as adjunctive therapy
Side Effects: fatigue, nausea, vomiting, abdominal pain, headache, dizziness,
somnolence, ataxia,
nystagmus, abnormal gait, Stevens-Johnson syndrome, toxic epidermal necrolysis,
diplopia, vertigo,
abnormal vision
Nursing Considerations: Monitor for & report S&S of hyponatremia or CNS impairment;
monitor
phenytoin levels; Lab tests: periodic serum sodium, T4 level; monitor plasma level
Drug Med Cards
1.16. Phenobarbital
(Solfoton)
Class: Anticonvulsant; Sedative-Hypnotic; Barbiturate
Actions: have anticonvulsant properties. Sedative and hypnotic effects appear to be
due primarily to
interference w/ impulse transmission of cerebral cortex by inhibition of reticular
activating system. Limiting
the spread of seizure activity results by increasing the threshold of motor cortex
stimulation. Peak: PO 8-
12 hr, IV 30 min Duration: IV 4-6 hr
Indications: Anticonvulsant, Status Epilepticus, Sedative/Hypmotic
Norm. Dosage, Freq, Route, Range: PO/IV 1-3 mg/kg/day in divided doses
Side Effects: Somnolence, nightmares, insomnia, “hangover”, headache, anxiety
Nursing Considerations: Observe patients receiving large doses for at least 30 min
to ensure that
sedation is not excessive, keep under observation, check IV site frequently,
monitor serum drug levels-
greater than 50 mcg/mL may cause coma, expect restlessness
1.17. Phenytoin
(Dilantin)
Class: Anticonvulsant; Hydantoin
Actions: Anticonvulsant action elevates the seizure threshold and/or limits the
spread of seizure discharge.
Accompanied by reduced voltage, frequency, and spread of electrical discharges w/in
the motor cortex.
Peak: Prompt Release: 1.5-3 hr Sustained Release: 4-12 hr
Indications: To control tonic-clonic (grand mal) seizures, psychomotor and
nonepileptic seizures (ex:
Reye’s syndrome). Used to prevent or treat seizures occurring during or
after neurosurgery. Not effective
for absence seizures.
Norm. Dosage, Freq, Route, Range: PO 15-20 mg/kg loading dose than 300 mg/day in 1-
3 divided doses,
may be gradually increased by 100 mg/week until seizures are controlled IV: 10-15
mg/kg then 300 mg/day
in divided doses
Side Effects: drowsiness, gingival hyperplasia, thrombocytopenia, leukopenia
Nursing Considerations: Monitor Vital signs, Lab tests: periodic serum phenytoin
concent., CBC w/
differential, platelet count, Hct, Hgb, serum glucose, serum calcium, serum
magnesium, and LFTs
1.18. Pregabalin
(Lyrica)
Class: Anticonvulsant; Gaba-analog; Analgesic/Miscellaneous; Anxiolytic
Actions: an analog of GABA that increases GABA levels and reduces calcium currents
in the calcium
channels of neurons. Peak: 1.5hr. Half-life:6hr.
Indications: management of neuropathic pain associated with diabetic peripheral
neuropathy or spinal
cord injury, adjunctive therapy for adult patietns w/ partial-onset seizures,
management of postherpetic
neuralgia, fibromyalgia
Norm. Dosage, Freq, Route, Range: PO 50-100mg tid Max: 300mg/day
Side Effects: accidental injury, ataxia, dizziness, somnlonce, peripheral edema,
weight gain, diplopia,
blurry vision
Nursing Considerations: Monitor for and report promptly mental status or behavior
changes (e.g.,
anxiety, panic attacks, restlessness, irritability, depression, suicidal thoughts).
Monitor for weight gain,
peripheral edema and S&S of heart failure. Monitor diabetics for increased
incidences of hypoglycemia.

Page 11 of 75
Drug Med Cards
1.19. Primidone
(Mysoline)
Class: Anticonvulsant; Barbiturate
Actions: effective as an anticonvulsant in all types of seizure disorders except
absent seizure. Peak: 4hr
Half-life: 3-24hr
Indications: management of complex partial and generalized tonic-clonic seizure
Norm. Dosage, Freq, Route, Range: PO 250mg/day increased by 250mg/wk Max: 2g/day in
2-4 divided
doses
Side Effects: drowsiness, sedation, vertigo, ataxia, headache, nausea, vomiting,
anorexia, leukopenia,
thrombocytopenia
Nursing Considerations: Lab tests: baseline and periodic CBC, complete blood
chemistry (q6mo), and
primidone blood levels (Therapeutic blood levels 5-10 mcg/mL). Monitor primidone
plasma levels
(concentrations greater than 10mcg/mL are usually associated w/ significant ataxia
and lethargy). Observe
for S&S of folic acid deficiency: mental dysfunction, psychiatric disorders,
neuropathy, and megaloblastic
anemia.
1.20. Valproic Acid

(Depakote, Depacon, Depakene)
Class: Anticonvulsant; GABA inhibitor
Actions: Anticonvulsant w/ increased bioavailability of the inhibitory
neurotransmitter GABA to brain
neurons. Peak: 1-4hrs.
Indications: Management of seizures; Migraine headache prophylaxis; Mania
Norm. Dosage, Freq, Route, Range: (seizures) PO/IV: 10-15mg/kg/day in divided doses
when total is
greater than 25mg. increase at 1wk. intervals bu 5-10mg/kg/day until seizures are
controlled Max:
60mg/kg/day (Mania) PO: 750mg/day administered in divided doses
Side Effects: sedation, drowsiness, deep coma, death (w/ overdose), nausea,
vomiting, indigestion, liver
failure, pancreatitis, prolonged bleeding time, bone marrow depression
Nursing Considerations: Lab tests: baseline platelet count, bleeding time,
coagulation, parameters, and
serum ammonia, LFTs, then repeat at least q2months of therapy, avoid alcohol

Drug Med Cards
5. Vitamins and Minerals

1.21. Multivitamin
(One-A-Day)
Class: Vitamins
Actions: Contain fat-soluble vitamins (A, D and E) and most water-soluble vitamins
(B-Complex vitamins
B1, B2, B3, B5, B6, B12, Vitamin C, Biotin, and Folic Acid). These vitamins are a
diverse group of
compounds necessary for growth and development. May act as coenzymes or catalysts
in numerous
metabolic processes. Onset, Peak, Duration: Unknown
Indications: Treatment and prevention of vitamin deficiencies.
Norm. Dosage, Freq, Route, Range: 1 dose unit (capsule, tablet,
dropperful)/day or amount
recommended by individual manufacturer
Side Effects: Urine discoloration, allergic reactions to preservatives, additives,
or colorants
Nursing Considerations: Asses patient for signs of nutritional deficiency before
and throughout therapy.
1.22. Omega-3 Fatty Acids

(Fish Oil, Omega-3 Fatty Acids)
Class: Nutritional Supplement, Omega-3 Fatty Acids
Actions: is not completely understood. May include inhibition of acetyl-CoA and
increased peroxisomal
beta-oxidation in the liver.
Indications: Hypertriglyceridemia
Norm. Dosage, Freq, Route, Range: PO 4 g daily as single or divided doses Max: 4
g/day
Side Effects: Back pain, flu syndrome, unspecified pain
Nursing Considerations: Monitor for S&S of hypersensitivity in those w/ known
allergy to fish, Lab tests:
baseline and periodic lipid profile

Page 13 of 75
Drug Med Cards
6. Steroid
1.23. Dexamethasone Sodium Phosphate
(Baycadron, Decadron, Dexamethasone)
Class: Adrenal Corticosteroid; Glucocorticoid
Actions: Long-acting synthetic adrenocorticoid with intense anti-inflammatory
activity and minimal
mineralocorticoid activity. Onset: Rapid Peak: PO 1-2 hr IM 8 hr Duration: PO 2.75
days IM 6 days Intra
lesional Intra-articular 1-3 weeks
Indications: Allergies, Inflammation, Neoplasias, Adrenocorticol Function
Abnormalities, Cerebral Edema,
Shock
Norm. Dosage, Freq, Route, Range: PO 0.25-4mg bid to qid IM 8-16mg q1-3weeks IV
0.75-0.9mg/kg/day
divided q6-12hr. Max: 16mg/day
Side Effects: Nasal Irritation, edema, hyperglycemia, impaired wound healing,
subacapsular cataract, oral
candidiasis
Nursing Considerations: take drug exactly as prescribed, report lack ir response to
med or malaise,
orthostatic hypotension, muscular weakness and pain, nausea, vomiting, anorexia,
hypoglycemic reaction,
or mental depression to prescriber, report any changes in appearance and easy
bruising
1.24. Fluticasone
(Flonase, Flovent)
Class: Synthetic steroids of glucocorticoid family of drugs
Actions: Fluticasone mimics the naturally-occurring hormone produced by the adrenal
glands, cortisol or
hydrocortisone. The exact mechanism of action of fluticasone is unknown.
Fluticasone has potent anti-
inflammatory actions. Onset: 1-3 wk. Peak: 4-8hr.
Indications: Seasonal allergy rhinitis
Norm. Dosage, Freq, Route, Range: Intranasal 100 mcg (1 inhalation) per nostril 1-2
times daily Max: 4
times daily
Side Effects: transient nasal irritation, burning, sneezing, epitaxis, bloody
mucous, nasopharyngeal
itching, dryness, crusting, and ulceration, headache, nausea, vomiting
Nursing Considerations: oral and nasal inhalers are not to be used interchangeably,
use of oral and
nasal inhaler provided by manufacturer should be carefully reviewed with patient
1.25. Triamcinolone Acetonide

(Nasacort HFA)
Class: Adrenal Corticosteroid, Glucocorticoid
Actions: Anti-inflammatory and immunosuppressant drug that is effective in the
treatment of bronchial
asthma. Onset: PO & IM 24-48hr. Peak: PO 1-2hr. IM 8-10hr. Duration: PO 2.25 days
IM 1-6wks.
Indications: Anti-inflammatory or immunosuppressant agent. Orally inhaled:
Bronchial asthma in patient
who has responded to conventional inhalation treatment. Does not suppress
hypothalamic-pituitary-
adrenal axis
Norm. Dosage, Freq, Route, Range: IM/SQ/Intra-auricle/Intradermal 4-48
mg/day in divided doses
Inhaled 2-4 inhalations
Side Effects: headache, nausea, vomiting, insomnia, confusion, peptic ulcer
Nursing Considerations: notify prescriber if wheezing occurs immediately following
a dose, monitor for
signs of negative nitrogen balance, lab tests: periodic serum electrolytes and
blood glucose

Drug Med Cards
7. Opiod
1.26. Fentanyl
(Duragesic)
Class: Opioid Analgesic
Actions: Binds to opiate receptors in the CNS, alters response and perception of
pain. Onset: IV
immediate, IM min. Transdermal: 12-24hr. Peak: IV 3-5min. Transdermal: 24-72hrs.
Duration: IV 30-60min
IM 1-2hr. Transdermal 72hrs.
Indications: For moderate to severe chronic pain requiring continuous opioid
analgesic therapy.
Norm. Dosage, Freq, Route, Range: 25-100mcg/hr. for 72hr. transdermal patch
Side Effects: CNS depression, do not drink or eat grapefruit, polypharmacy
Nursing Considerations: BP, Pulse, Respirations <6 need Narcan
1.27. Hydrocodone Bitartrate

(Mycodone)
Class: Narcotic (Opiate Agonist) Analgesic; Antitussive
Actions: CNS suppressant with moderate to severe pain relief of pain. Suppress
cough reflex by direct
action on cough center in medulla. Onset: 10-20 min Duration: 3-6 hr
Indications: Mild to Moderate pain, Cough
Norm. Dosage, Freq, Route, Range: 5-10 mg q4-6hr PRN Max: 60 mg/day
Side Effects: constipation, nausea, drowsiness, respiratory depression
Nursing Considerations: Monitor for effectiveness of drug for pain relief, nausea
and vomiting, respiratory
status and bowel elimination
1.28. Hydromorphone
(Dilaudid)
Class: Narcotic, Analgesic
Actions: Potent opiate receptor agonist that does not alter pain threshold but
changes the perception of
pain in CNS. An effective narcotic analgesic that controls mild to moderate pain;
has antitussive properties.
Onset: IV 15min., PO 30min. Peak: 30-90min. Duration: 3-4hrs.
Indications: Relief of moderate to severe pain
Norm. Dosage, Freq, Route, Range: PO 2.5-10 mg q4-6hr Max: 60mg/day
SQ/IM/IV 0.75-2 mg q4-6hr Max: 12 mg/day
Side Effects: Nausea, vomiting, constipation, drowsiness, hypotension,
tachycardia, respiratory
depression
Nursing Considerations: Baseline respiratory rate, rhythm, and depth & size
of pupils;; respirations ↓
12/min. or less & mitosis are signs of toxicity, monitor vital signs at reg.
intervals, monitor I&O ratio & pattern
for urinary retention, monitor bowel pattern, √ for nausea/vomiting and
orthostatic hypotension.

Page 15 of 75
Drug Med Cards
1.29. Morphine Sulfate

(Astramorph PF, Avinza, Depo-Dur, Duromorph)
Class: Analgesic, Narcotic (opiate agonist)
Actions: Controls severe pain, also used as an adjunct to anesthesia. Peak: PO
60min. PR 20-60min.
SQ 30-60min. IM 30-60min. IV 20min. Duration: 7hr.
Indications: Pain relief
Norm. Dosage, Freq, Route, Range: PO 10-30 mg q4hr or 15-30 mg sustained release
q8-12hr Max:
180 mg/day IV 2.5-15 mg/70kg q2-4hr or 0.8-10 mg/hr by continuous infusion, may
increase PRN to control
pain or 5-10 mg given epidurally q24hr IM/SQ 5-20 mg q4hr PRN Max: 120 mg/day PR10-
20 mg q4hr PRN
Max: 120 mg/day
Side Effects: hypersensitivity, nausea, vomiting, constipation, urinary retention
Nursing Considerations: Baseline respiratory rate, rhythm and depth and size of
pupils, respirations
12/min and ↓and miosis are signs of toxicity, assess vital signs at
regular intervals, encourage changes in
positions, deep breathing, and coughing at regular intervals,
Monitor I&O, √ for nausea and orthostatic
hypotension
1.30. Oxycontin
Class: Narcotic (opiate agonist); Analgesic
Actions: Semisynthetic derivative of an opium agonist the binds with stereo-
specific receptors in various
sites of CNS to alter both perception of pain and emotional response to pain.
Onset: 10-15 min. Peak: 30-
60 min. Duration: 4-5 hr.
Indications: Moderate to severe pain
Norm. Dosage, Freq, Route, Range: PO 5-10 mg q6hr (may titrate up to 10-30 mg q4hr
PRN) Immediate-
release 10 mg q12hr (may titrate up) Max: 180 mg/day
Side Effects: sedation, constipation, light-headedness, dizziness, fainting,
hepatotoxicity
Nursing Considerations: Monitor patient’s response closely, especially to
sustained-release preparations,
Lab tests: monitor LFTs and hematologic status periodically in patients on high
dose, evaluate patients
continued need
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Drug Med Cards
8. Opiod Antagonists
1.31. Naloxone
(Narcan)
Class: Opioid Antagonist
Actions: A potent narcotic antagonist, essentially free of agonistic (morphine-
like) properties. Reverses
the effects of opiates, including respiratory depression, sedation, and
hypotension. Onset: 2 min Duration:
45 min
Indications: Opiate Overdose
Norm. Dosage, Freq, Route, Range: IV 0.4-2mg, may repeat q2-3min up to 10mg if
necessary Max:
10mg
Side Effects: increased BP, tachycardia, nausea, vomiting
Nursing Considerations: Observe patient closely; duration of action of some
narcotics may exceed that
of naloxone. Keep prescriber informed
1.32. Naltrexone HCL

(Vivitrol)
Class: Narcotic (opiate Antagonist)
Actions: Weakens or completely and reversibly blocks the subjective effects
(the “high”) of IV opioids and
analgesics possessing both agonist and antagonist activity. Onset: 15-30min Peak:
1hr. Duration: PO 24-
72hr. IM 4wk.
Indications: Opioid Dependence; Alcohol Dependence
Norm. Dosage, Freq, Route, Range: PO 25mg followed by another 25mg in 1hr. if no
withdrawal
response; maintenance regimen of 50-150mg/day is individualized Max: 800mg/day IM
380mg q4wk
Side Effects: nausea, vomiting, abdominal cramps/pain, hepatotoxicity, muscle &
joint pains, difficulty
sleeping, anxiety, headache, nervousness
Nursing Considerations: Lab tests: check LFTs before the treatment is started, at
monthly intervals for 6
months, and then periodically as indicated; do not self-medicate w/ OTC drugs;
report promptly onset of
signs of hepatic toxicity to prescriber

Page 17 of 75
Drug Med Cards
9. NSAIDS
1.33. Celecoxib
(Celebrex)
Class: Analgesic; NSAID; Cyclooxygenase-2 (Cox-2) Inhibitor; Anti-inflammatory
Actions: Exhibits anti-inflammatory; analgesic, and antipyretic activities. Reduces
or eliminates the pain
of rheumatoid and osteoarthritis. Peak: 3 hr
Indications: Osteoarthritis/Arthritis/Ankylosing Spondylitis, Rheumatoid Arthritis
Norm. Dosage, Freq, Route, Range: PO 100mg bid Max: 200mg
Side Effects: back pain, dizziness, headache, insomnia, diarrhea, abdominal pain
Nursing Considerations: Lab tests: periodically monitor Hct and Hgb, Lfts, BUN, and
Creatinine and
serum electrolytes, monitor closely lithium levels, monitor closely PT/INR, monitor
for fluid retention and
edema
1.34. Indomethacin
(Indocin)
Class: Analgesic, Non-steroidal Anti-inflammatory (NSAID)
Actions: It is a potent analgesic, anti-inflammatory, and antipyretic agent.
Promotes closure of persistent
patent ductus arteriosus. Onset 1-2 hr. Peak: 3 hr. Duration: 4-6 hr.
Indications: palliative treatment in active stages of moderate to severe rheumatoid
arthritis, ankylosing
rheumatoid spondylitis, acute gouty arthritis, and osteoarthritis of hip in
patients intolerant to or
unresponsive to adequate trials with salicylates and other therapy. Also used IV to
close patent ducus
arteriosus in the premature infant.
Norm. Dosage, Freq, Route, Range: PO/PR: 50 mg tid until pain is tolerable, then
rapidly taper Max: 150
mg/day
Side Effects: dizziness, tinnitus, nausea, vomiting
Nursing Considerations: Monitor for effectiveness, question patient carefully
regarding aspirin sensitivity
before initiation of therapy, observe patients carefully, Lab tests: monitor renal
function, LFTs, CBC w/
differential, BP and HR, visual and hearing acuity periodically
1.35. Ketorolac
(Acular, Acuvail, SPRIX)
Class: Analgesic, NSAID, Anti-inflammatory, Antipyretic
Actions: It inhibits synthesis of prostaglandins by inhibiting both COX-1 and COX-2
enzymes. Is a
peripherally acting analgesic. It inhibits platelet aggregation and prolongs
bleeding time. Peak: 46-60 min
Indications: Pain
Norm. Dosage, Freq, Route, Range: IV loading dose 30mg Max: 150mg/day on the first
day then
120mg/day subsequent days
Side Effects: drowsiness, nausea
Nursing Considerations: Lab tests: periodic serum electrolytes and LFTs; urinalysis
(for hematuria and
proteinuria) with long-term use, monitor urine output, monitor for S&S of GI
distress or bleeding including
nausea, GI pain, diarrhea, melena, or hematemesis, GI ulceration with perforation
can occur anytime during
treatment

Drug Med Cards
10. Analgesic, Antipyretic

1.36. Acetominophen
(Tylenol)
Class: Nonnarcotic analgesic, Antipyretic
Actions: provides temp. relief for mild to mod. pain, ↓ body temp. in
indiv. w/ fever. Peak: 0.5-2 hr. Duration:
3-4 hr.
Indications: Fever Reduction. Temporary relief of mild to moderate pain. Generally
as substitute for
aspirin when the latter is not tolerated or is contraindicated
Norm. Dosage, Freq, Route, Range: PO: 325-650 mg q4h Max: 4 g/day PR: 650 mg q4h
Max: 4 g/day
Side Effects: Hepatotoxicity, hepatic coma, acute renal failure
Nursing Considerations: Hepatotoxicity, even w/ mod. acetaminophen doses,
especially in individuals
with poor nutrition or who have ingested alcohol (3+ drinks daily) over prolonged
periods; poisoning, usually
from accidental ingestion or suicide attempts; potential abuse from psychological
depend., do not take other
meds containing acetaminophen, do not self-medicate adults for pain more than 10
days w/o consulting a
doctor, do not use this med w/o medical direction for: fever persisting longer than
3 days, fever over 103,
or recurrent fever
1.37. Acetaminophen Suppository

(Tylenol Suppository)
Class: Antipyretic, Non-opioid Analgesic
Actions: Analgesic; Antipyresis. Peak: 0.5-2hrs. Duration: 3-4hrs.
Indications: Mild pain, fever
Norm. Dosage, Freq, Route, Range: PR 325-650mg q4-6hr. or 1gram 3xday
Side Effects: Hepatic failure, renal failure, neutropenia, rash urticaria
Nursing Considerations: Polypharmacy, renal-liver function, pain level, toxicity
1.38. Aspirin
(ASA)
Class: Non-narcotic, Antiplatelet, Antipyretic
Actions: inhibiting the formation of prostaglandins involved in the production of
inflammation, pain and
fever, powerfully inhibits platelet aggregation. High serum salicylate
concentrations can impair hepatic
synthesis of blood coagulation factors VII, IX, X. Peak: 15min-2hr.
Indications: Anti-inflammatory action, pain, fever reducer, antiplatelet
Norm. Dosage, Freq, Route, Range: PO: 350-650 mg q4h Max: 4 g/day
Side Effects: Bronchospasm, anaphylactic shock (laryngeal edema), nausea,
heartburn, stomach pains,
thrombocytopenia, hemolytic anemia
Nursing Considerations: Allergy to any ASA, monitor for salicylate toxicity. In
adults, a sensation of
fullness in the ears, tinnitus, and decreased or muffled hearing are the most
frequent symptoms.

Page 19 of 75
Drug Med Cards
11. Anticholinergic
1.39. Oxybutynin Cl
(Anutrol, Ditropan, Gelnique, Oxytrol)
Class: Anticholinergic; Antimuscaring; GU Antispasmodic
Actions: Synthetic tertiary amine that exerts direct antispasmodic action and
inhibits muscarinic effects of
acetylcholine on smooth muscle of the urinary muscle. Onset: 0.5-1hr. Peak: 3-6hrs.
Duration: 6-10hrs.
Indications: Overactive Bladder
Norm. Dosage, Freq, Route, Range: PO 5mg 2-4x/day Max: 20mg/day
Side Effects: drowsiness, blurred vision, dry mouth, constipation, pruritus at
application site (topical)
Nursing Considerations: periodic interruptions of therapy are recommended to
determine pt.’s need for
continued treatment, tolerance has occurred in some pt.’s;; keep
prescriber informed of expected responses
to drug therapy (e.g., effect on urinary frequency, urgency, urge incontinence,
nocturia, completeness of
bladder emptying)
1.40. Glycopyrrolate
(Robinul, Robinul Forte)
Class: Anticholinergic, Antimuscarinic, Antipasmodic
Actions: Inhibits motility of GI and genitourinary tract, it also decreases volume
of gastric and pancreatic
secretions, saliva, and perspiration. Onset: PO: 1 hr., IV: 1 min., IM/SQ: 15-30
min Peak: PO: 1 hr., IM/SQ:
30-45 min. Duration: PO: 8/12 hr., IM/SQ: 2-7 hr.
Indications: Adjunctive management of peptic ulcer and other GI disorders
associated with hyperacidity
Norm. Dosage, Freq, Route, Range: PO: 1 mg tid or 2 mg bid or tid in equally
divided intervals Max; 8
mg/day
Side Effects: Decreased sweating, Xerostomia, Urinary hesitancy or retention
Nursing Considerations: Monitor I&O ratio and pattern particularly in older adults,
Monitor vital signs,
especially when drug is given parenterally. Report any changes in heart rate and
rhythym.

Drug Med Cards
12. Bronchodilator
1.41. Albuterol
(Proventil, Ventolin)
Class: Bronchodilator (Resp. Smooth Muscle Relaxant); Beta-Adrenergic Agonist
Actions: Bronchodilation decreased airway resistance; facilitates mucous drainage,
and increases vital
capacity. Onset: Inhaled 5-15 min PO 30 min Peak: 0.5-2 hr PO 2.5 hr Duration:
inhaled3-6 hr PO 4-6 hr
(8-12hr w/ sustained release)
Indications: Bronchospasm
Norm. Dosage, Freq, Route, Range: PO 2-4 times/day, 4-8 mg sustained release 2
times/day Inhaled:
1-2 inhalations q4-6hr
Side Effects: Tremor, anxiety, nervousness, headache, restlessness
Nursing Considerations: Monitor effectiveness, Monitor S&S of fine tremor in
fingers, Lab Tests: periodic
ABGs, PFTs, pulse oximetry

Page 21 of 75
Drug Med Cards
13. Thyroid Hormone Replacement

1.42. Levothyroxine
(Synthroid)
Class: Thyroid Hormone Replacement
Actions: Raises T3 and T4 levels, Normal levels: 0.3-3, Restores metabolic rate.
Peak: 3-4wks. Duration:
1-3wks.
Indications: Specific replacement therapy for diminished or absent thyroid function
Norm. Dosage, Freq, Route, Range: PO 25-50 mcg/day Max: 400 mcg/day
Side Effects: insomnia, headache, irritability, nervousness, palpitations
Nursing Considerations: monitor T3, & T4 levels, H.R., B.P., PT/INR

Drug Med Cards
14. Alpha Adronergic Receptor Antagonist

1.43. Tamsulosin HCL
(Flomax)
Class: Alpha Adrenergic Receptor Antagonist
Actions: effectiveness is indicated by improved voiding. Improves symptoms related
to BPH related to
bladder outlet obstruction. Peak: 4-5hr. fasting 6-7hr. fed Half-life: 14-15hr.
Indications: BPH
Norm. Dosage, Freq, Route, Range: PO 0.4mg daily 30 min after meal Max 0.8mg/day
Side Effects: headache, dizziness, orthostatic hypotension, rhinitis, abnormal
ejaculation
Nursing Considerations: Monitor for signs of orthostatic hypotension

Page 23 of 75
Drug Med Cards
15. Antiparkinson (Cholinergic Receptor Antagonist

1.44. Benztropine Mesylate
(Cogentin)
Class: Centrally Acting Cholinergic Receptor Antagonist; Antiparkinson
Actions: Synthetic centrally acting anticholinergic agent that acts by diminishing
excess cholinergic effects
associated w/ dopamine deficiency. Onset: IM/IV 15min. PO 1hr. Duration: 6-10hrs.
Indications: Parkinsonism; Extrapyramidal reactions; Acute Dystonia
Norm. Dosage, Freq, Route, Range: PO/IM 0.5-1mg/day may gradually increase as
needed up to
6mg/day
Side Effects: sedation, constipation, dry mouth, paralytic ileus
Nursing Considerations: Monitor I&O ratio and pattern, monitor HR, monitor and
report for muscle
weakness
1.45. Donepezil
(Aricept)
Class: Central Acting Cholinergic; Cholinesterase Inhibitor
Actions: improves global function, cognition, and behavior of patients with mild to
moderate Alzheimer’s.
Peak: 3-4hr. Half-life: 70hr.
Indications: mild, moderate, or severe dementia of Alzheimer’s type.
Norm. Dosage, Freq, Route, Range: PO 5-10mg at bedtime Max: 10mg/day
Side Effects: headache, insomnia, nausea, diarrhea, vomiting, muscle cramps,
anorexia
Nursing Considerations: Monitor closely for S&S of GI ulceration and bleeding,
monitor cardiovascular
status, exercise caution
1.46. Ropinirole HCL

(Requip)
Class: Dopamine Receptor Agonist; Antiparkinson
Actions: effectiveness indicated by improvement in idiopathic Parkinson’s
disease. Peak: 1-2hr. Half-life:
6hr.
Indications: Idiopathic Parkinson’s disease, restless leg syndrome
Norm. Dosage, Freq, Route, Range: PO 0.25-4mg Max: 4mg
Side Effects: fatigue, viral infection, dizziness, somnolence, sudden sleep
attacks, syncope, nausea,
vomiting, dyspepsia
Nursing Considerations: Lab tests: periodically monitor BUN and creatinine, hepatic
function and cardiac
status

Drug Med Cards
1.47. Trihexyphenidyl HCL

(Artane)
Class: Centrally Acting Cholinergic Receptor Antagonist; Antiparkinson Agent;
Antispasmodic
Actions: thought to act by blocking excess of acetylcholine at certain cerebral
synaptic sites. Relaxes
smooth muscle by direct effect and by atropinelike blocking action on the PNS.
Onset: w/in 1 hr. Peak: 2-
3hr. Duration: 6-12hrs.
Indications: Parkinsonism; Extrapyramidal reactions
Norm. Dosage, Freq, Route, Range: PO 1mg day 1, 2mg day 2 then increased 2mgq3-
5days up to 6-
10mg/day in 3 or more divided doses Max: 15mg/day
Side Effects: dry mouth, nausea, blurred vision, dizziness, nervousness
Nursing Considerations: Monitor vital signs, assess and report severe CNS
stimulation, monitor daily
I&O if pt. develops urinary hesitancy

Page 25 of 75
Drug Med Cards
16. Fluid and Electrolytes

1.48. Calcium Acetate
(Norvasc)
Class: Calcium Channel Blocker; Antihypertenive
Actions: reduces systolic, diastolic, and mean arterial blood pressure. It also
decreases pain due to
angina. Peak: 6-9hr. Duration: 24hr. Half-life: less than 45yrs: 28-69hr. greater
than 60yrs: 40-120hr.
Indications: treatment of mild to moderate hypertension and stable angina
Norm. Dosage, Freq, Route, Range: PO 5-10mg once daily Max: 10mg
Side Effects: peripheral or facial edema, headache, abdominal pain, nausea
Nursing Considerations: Monitor BP& HR, monitor for S&S of dose-related peripheral
or facial edema,
monitor BP w/ postural changes
1.49. Dextrose 50%

(Dextrose, D50, D50W, Glucose)
Class: Monosaccharide, principal form of charbohydrate used in the body
Actions: Increase blood serum glucose levels. Onset: 5-20min
Indications: hypoglycemia, coma or seizure of unknown etiology, refractory cardiac
arrest
Norm. Dosage, Freq, Route, Range: ½ to 1 full amp slow IV (25-100mL of 50%
solution)
Side Effects: pain, warmth, burning upon admin, phlebitis, sclerosis, thrombosis,
Nursing Considerations: if smaller veins are used, local venous irritation may
occur, infiltration may cause
necrosis
1.50. Ergocalciferol
(Calcidol, D-ViSol, Vitamin D2)
Class: Vitamin D Analog
Actions: distributed through the circulation and plays a major regulatory role.
Responsible for regulation
of serum calcium level.
Indications: Nutritional Rickets, Osteomalacia, Hypoparathyroidism
Norm. Dosage, Freq, Route, Range: PO 25-125 mcg/day for 6-12 weeks; may need to
increase to 7.5
mg/day in patients w/ malabsorption. Peak: after 4 weeks Duration: 2 months or
more.
Side Effects: fatigue, weakness, vertigo, tinnitus, ataxia, muscle and joint pain
Nursing Considerations: Monitor closely patients receiving therapeutic doses of
Vitamin D, must remain
under close medical supervision, Lab tests: Serum calcium, phosphorus, magnesium,
alkaline,
phosphatase, BUN, periodic urine calcium, casts, albumin, and RBC, Monitor for
hypercalcemia

Drug Med Cards
1.51. Ferrous Sulfate

(Feosol)
Class: Iron prepartion
Actions: Standard iron preparation that corrects erythropoietic abnormalities
induced by iron deficiency
but does not stimulate erythropoiesis. Absorption: 5-10% absorbed in healthy
individuals; 10-30%
absorbed in iron deficiency; food decreases amount absorbed
Indications: Iron deficiency, Iron supplement
Norm. Dosage, Freq, Route, Range: PO 750-1500 mg/day in 1-3 divided doses Max: 1500
mg
Side Effects: nausea, heartburn, constipation, black stools
Nursing Considerations: Lab tests: monitor Hgb and reticulocyte values during
therapy, continue iron
therapy for 2-3 months after the hemoglobin level has returned to normal, monitor
bowel movements as
constipation is common
1.52. Magnesium Hydroxide

(Magnesia, Magnesia Magna, Milk of Magnesia, M.O.M.)
Class: Saline Cathartic; Antaid
Actions: Aqueous suspension of magnesium hydroxide w/ rapid and long-acting
neutralizing action.
Causes osmotic retention of fluid, which distends colon, resulting in mechanical
stimulation of peristaltic
activity. Onset: 3-6hrs.
Indications: Laxative
Norm. Dosage, Freq, Route, Range: PO 2.4-4.8g/day (30-60mL) in 1 or more divided
doses.
Side Effects: nausea, diarrhea, complete heart block, other ECG abnormalities,
respiratory depression,
coma
Nursing Considerations: Lab tests: monitor serum magnesium w/ signs of
hypermagnesemia such as
bradycardia, especially w/ frequent use of any degree of renal impairment
1.53. Potassium Chloride

(KCl)
Class: Electrolytes replacement solution
Actions: For maintenance of intracellular isotonicity, transmission of nerve
impulses, contraction of
cardiac, skeletal and smooth muscles, normal kidney function and enzyme activity
Indications: Potassium replacement
Norm. Dosage, Freq, Route, Range: PO 10-100 mEq/day in divided doses Max: 100
mEq/day in divided
doses
Side Effects: Bacteremia, dizziness, edema, fatigue, fever, headache, infection,
insomnia, rigors,
hypertension, hypotension, tachycardia, abdominal pain, anorexia, constipation,
diarrhea, dyspepsia,
mucositis, nausea, anemia, febrile neutropenia, neutropenia, petechiae,
thrombocytopenia, bilirubinemia,
hyperglycemia, hypokalemia, hypomagnesemia, arthralgia, back pain, musculoskeletal
pain, cough,
dyspnea, epistaxis, pharyngitis, pruritus, rash, vaginal hemorrhage
Nursing Considerations: Check serum K+ level, Normal level: 3.5-5.0, monitor I&O
renal function
Page 27 of 75
Drug Med Cards
17. Antibiotics
1.54. Amoxicillin & Clavulanic Acid
(Augmentin)
Class: Beta-Lactam, Antibiotic, Aminopenicillin
Actions: Inhibits the final stage of bacterial cell wall synthesis , which leads to
cell lysis and death. Peak:
1-2hrs.
Indications: Infections caused by susceptible beta-lactamase-producing organisms,
lower respiratory tract
infections, acute bacterial sinusitis, community acquired pneumonia, otitis media,
sinusitis, skin and skin
structure infections, UTI
Norm. Dosage, Freq, Route, Range: PO: 250-500 mg tablet Max:1500 mg/day
Side Effects: Diarrhea, agranulocytosis (rare)
Nursing Considerations: determine previous hypersensitivity reactions to
penicillins, cephalosporins and
other allergens prior to therapy, Lab tests: baseline C&S prior to initiation of
therapy; start drug pending
results, monitor for S&S of an urticarial rash (usually occurring within a few days
after start of drug)
suggestive of a hypersensitivity reaction, monitor for and report diarrhea which
may indicate
pseudomembranous colitis
1.55. Amoxicillin
(Amoxil)
Class: Antibiotic, Aminopenicillin
Actions: Inhibits the final stage of bacterial cell wall synthesis, which results
in bacterial cell lysis and
death. Active against both aerobic gram-positive & aerobic gram negative bacteria.
Onset: 1-2hr. Duration:
1-1.3hr.
Indications: mild to moderate infections of ear, nose, throat, GU tract, skin, and
soft tissue caused by
susceptible bacteria, used in uncomplicated Gonorrhea
Norm. Dosage, Freq, Route, Range: PO 250-500 mg q8h Max: 60-80 mg/kg/day
Side Effects: Anaphaylaxis, pseudomembranous colitis (rare), agranulocytosis
(rare), hypersensitivity
Nursing Considerations: determine previous hypersensitivity reactions to
penicillins, cephalosporins and
other allergens prior to therapy, Lab tests: Baseline C&S tests prior to initiation
of therapy; start drug
pending results, periodic assessment of renal, hepatic and hematologic functions w/
prolonged therapy.
1.56. Ampicillin
(Principen)
Class: Antibiotic; Aminopenicillin
Actions: A broad-spectrum, semi synthetic aminopenicillin that is bactericidal but
is inactivated by
penicillinase. Inhibits final stage of bacterial cell wall synthesis by binding to
specific penicillin-binding
proteins located inside the bacteria cell wall resulting in lysis and death of
bacteria. Peak: Immed. After IV
Duration: 6-8hrs.
Indications: Infections of the GU, respiratory and GI tracts, and skin and soft
tissues; gonococcal
infections, bacterial meningitis, otitis media, sinusitis and septicemia and for
prophylaxis of bacterial
endocarditis. Used parentally only for moderately severe to severe infections.
Norm. Dosage, Freq, Route, Range: PO/IV/IM 250-500 mg q6hr Max: 2000 mg/day
Side Effects: Diarrhea, nausea, vomiting, rash

Drug Med Cards
Nursing Considerations: √ for allergies to penicillin’s, cephalosporin’s

and other allergens prior to
therapy, monitor closely for signs of hypersensitivity during the first 30 min.
after admin., Lab tests: baseline
C&S prior to admin., baseline & periodic renal assessment, monitor for diarrhea
(may indicate
pseudomembranous colitis)
1.57. Ceftriaxone Sodium

(Rocephin)
Class: Antibiotic, 3rd generation Cephalosporin
Actions: preferentially binds to one or more of the penicillin-binding proteins
located on the cell walls on
susceptible organisms. Peak: 1.5-4hr after IM, immediately after IV Half-life: 5-
10hr
Indications: infections in lower respiratory tract, skin and skin structures,
urinary tract, bones and joints,
intra-abdominal infections, pelvic inflammatory disease, uncomplicated gonorrhea,
meningitis, and surgical
prophylaxis
Norm. Dosage, Freq, Route, Range: IV/IM: 1-2g q12hr x 4-14days Max: 4g/day
Side Effects: diarrhea, abdominal cramps
Nursing Considerations: hypersensitivity, Lab tests: culture & sensitivity before
initiation of therapy,
periodic PT & INR, report diarrhea promptly
1.58. Clindamycin HCL

(Cleocin)
Class: Lincosamide Antibiotic
Actions: Semisynthetic derivative if lincomycin that suppresses protein synthesis
by binding to 50 S
subunits of bacterial ribosomes, and, therefore, inhibits other antibiotics (ex:
erythromycin) that act at this
site. Peak: PO 45-60 min IM 3 hr Duration: PO 6 hr IM 8-12 hr
Indications: Moderate to severe infections, Acne Vulgaris, Bacterial Vaginosis
Norm. Dosage, Freq, Route, Range: PO 150-450 mg q6hr IM/IV 600-1,200 mg/day in
divided doses Max:
2,700 mg/day
Side Effects: Diarrhea, nausea, vomiting, skin rashes
Nursing Considerations: Lab tests: C&S susceptibility testing should be performed
initially, periodic CBC
with differential, liver and kidney function tests, monitor BP and pulse in
patients receiving drug parenterally,
report diarrhea immediately with or w/o fever, be alert for signs of superinfection
and anaphylactoid
reactions
1.59. Cortisporin gtts

(Cortisporin-TC)
Class: Ophthalmic steroid, antibiotic (Suspension Only)
Actions: Ear drops used to treat outer ear infections caused by bacteria (aka
swimmer's ear). Contains
neomycin and colistin, which are antibiotics that work by stopping the growth of
bacteria. Also
contains hydrocortisone, which is an anti-inflammatory corticosteroid that works by
reducing ear swelling
and discomfort, and thonzonium, which helps this med pass through dead cells and
pus inside the ear.
Indications: Only works for bacterial ear indications
Norm. Dosage, Freq, Route, Range: 4 drops in affected ear 3-4 times daily Max: 16
drops/day
Side Effects: This medication may temporarily sting or burn your ear for a minute
or two when applied.
Hearing problems, rash, itching/swelling, redness of the ears, dizziness
Nursing Considerations: √ for allergies, rash, redness, itching or swelling
to the ears, or any hearing
problems

Page 29 of 75
Drug Med Cards
1.60. Doxycycline Hyclate

(Doryx, Doxy)
Class: Antibiotic; Tetracycline
Actions: blocks the binding of transfer RNA to the messenger RNA of bacteria,
resulting in inhibition of
bacterial protein synthesis. Peak: 1.5-4hr Half-life 14-24hr
Indications: treatment of chlamydial and mycoplamal infections, gonorrhea, syphilis
in penicillin-allergic
patients, rickettsial diseases, acute exacerbations of chronic bronchitis
Norm. Dosage, Freq, Route, Range: PO/IV 100mg q12hr on day 1, than 100mg/day as
single dose Max:
100mg/q12hr
Side Effects: nausea, vomiting, diarrhea
Nursing Considerations: report sudden onset of painful or difficult
swallowing and evidence of
superinfections
1.61. Gentamicin Ointment

(Garamycin Ophthalmic)
Class: Aminoglycoside Antibiotic
Actions: Active against a wide variety of aerobic gram-negative but not anaerobic
gram-negative bacteria.
Also effective against certain gram-positive organisms, particularly penicillin-
sensitive bacteria
Indications: Moderate to Severe Infection
Norm. Dosage, Freq, Route, Range: Topical 1-2 drops of solution in eye q4hr up to 2
drops q1hr or small
amount of ointment bid or tid
Side Effects: decreased creatinine clearance
Nursing Considerations: Lab tests: perform C&S and renal function prior to first
dose and periodically
during therapy, watch Creatinine clearance levels, report S&S of ototoxic effect
1.62. Levofloxacin
(Levaquin, Iquix, Quixin)
Class: Quinolone Antibiotic
Actions: A broad-spectum fluoroquinolone antibiotic that inhibits DNA-gyrase, an
enzyme necessary for
bacterial replication, transcription, repair, and recombination. Peak: PO 1-2 hr.
Half-life: 6-8 hr.
Indications: treatment of maxillary sinusitis, acute exacerbations of bacterial
bronchitis, community-
acquired pneumonia, uncomplicated skin/skin structure infections, UTI, acute
pyelonephritis caused by
susceptible bacteria, acute bacterial sinusitis, chronic bacterial prostatitis, nd
bacterial conjunctivitis,
treatment of pneumonic and septicemic plague.
Norm. Dosage, Freq, Route, Range: PO: 500 mg q24hr x 10 days
Side Effects: abdominal pain, nausea, headache, depression
Nursing Considerations: Monitor for decreases pulse, perspiration, or pallor during
insertion. Keep
patient supine until these signs disappear, Monitor BP

Drug Med Cards
1.63. Linezolid
(Zyvox)
Class: Oxazolidinone Antibiotic
Actions: Synthetic antibiotic that binds to a site on the 23S ribosomal RNA of
bacteria, which prevents the
bacterial RNA translation process, thus preventing further growth. Peak: PO 1-2 hr.
Half-life: 6-7 hr.
Indications: Vancomycin-Resistant Enterococcus faecium, Nosocomial
or community-acquired
pneumonia, complicated and uncomplicated skin infections
Norm. Dosage, Freq, Route, Range: PO/IV: 600 mg q12hr x 14-28 days Max: 1,200
mg/day
Side Effects: diarrhea, nausea, vomiting, constipation, taste alteration
Nursing Considerations: Monitor S&S of bleeding, hypertension, or pseudomembranous
colitis that
begins w/ diarrhea, Lab tests: CBC, platelet count, Hgb, and Hct
1.64. Ofloxacin
(Floxin)
Class: Quinolone Antibiotic
Actions: Inhibits DNA gyrase, an enzyme needed for bacterial DNA replication, broad
spectrum against
gram +&- most effective against gram – aerobic and anaerobic bacteria. Peak 1-2hr.
Half-life: 5-7.5hr.
Indications: Gonorrhea; Prosistitis; RTI (PO) OTIC (Tympanic) and Ocular; PID
Norm. Dosage, Freq, Route, Range: 0.3% Opthalmic solution 1-2GTTs q2-4hr, qid
0.3% Otic solution GTTS q12hr. x days
Side Effects: Dizziness, N&V, DTS menorrhea, menorrhagia, dysuria, urinary
frequency
Nursing Considerations: C&S, tendon PN, rash, seizures, S&S super infection
1.65. Vancomycin
(Vancocin)
Class: Antibiotic, Bacteriocidal
Actions: Active against many gram-positive organisms. Inhibits cell-wall
biosynthesis and alteration of
bacterial cell-membrane permeability and RNA synthesis. Peak: 30min after end of
infusion Half-life: 4-8hr.
Indications: Infections
Norm. Dosage, Freq, Route, Range: (C. Diff.) PO 125-500 mg q6h (Staph) PO 500 mg-2
g in 3-4 divided
doses x 7-10 days Max: 2 g/day
Side Effects: Nephrotoxicity leading to uremia, shock-like state, anaphylactoid
reaction w/ vascular
collapse, leukopenia, hypotension accompanied by flushing and erythematous rash on
face and upper body
(red-man syndrome) following rapid IV infusion
Nursing Considerations: Allergy, monitor BP and HR, take peak & trough levels,
assess hearing. Be
aware that serum levels of 60-80 mcg/ml are associated w/ ototoxicity, monitor I&O.
Oliguria or cloudy or
pink urine may be a sign of nephrotoxicity

Page 31 of 75
Drug Med Cards
18. Cholesterol Lowering Agents

1.66. Atorvastatin
(Lipitor)
Class: Anti-lipemic, HMG-COA, Reductase Inhibitor (statin)
Actions: Adjunct to diet for reduction of LDL cholesterol and triglycerides in
patients with primary
hypercholesterolemia and mixed dyslipidemia, prevention of cardiovascular disease
in patients with
multiple risk factors. Onset: 2 wk. Peak: Plasma concentration 1-2 hr. effect 2-4
wk.
Indications: Lowers LDL cholesterol, prevention of cardiovascular disease
Norm. Dosage, Freq, Route, Range: PO start w/ 10-40 mg daily may increase up to 80
mg/day Max: 80
mg/day
Side Effects: Back pain, hypersensitivity reaction, headache, abd. pain,
constipation, diarrhea, flatulence,
increased liver function tests, sinusitis, pharyngitis, rash
Nursing Considerations: Lab tests: monitor lipid levels within 2-4 weeks after
initiation of therapy or upon
change in dosage, assess muscle pain, tenderness or weakness and if present,
monitor CPK level (d/c
drug with marked elevations of CPK or if myopathy is suspected, monitor carefully
for digoxin toxicity with
concurrent digoxin use, monitor prediabetics and diabetics for loss of glycemia.
1.67. Cholestyramine
(Questrane, Prevalite)
Class: Antilipemic; Bile Acid Sequestrant
Actions: increase fecal loss of bile acids, which leads to lowered serum total
cholesterol by decreasing
LDL cholesterol, and reducing bile acid deposit in dermal tissues.
Indications: as adjunct to diet therapy in management of patients w/ primary
hypercholesterolemia w/ a
significant risk of atherosclerotic heart disease and MI; for relief of pruritus
secondary to partial biliary stasis
Norm. Dosage, Freq, Route, Range: PO 4-8g bid to qid and before meals and at
bedtime Max: 32g/day
Side Effects: constipation, flatulence, abdominal pain
Nursing Considerations: Monitor for petechiae, ecchymoses, abnormal
bleeding from mucous
membranes, tarry stools
1.68. Fenofibrate
(Tricor)
Class: Antilipemic; Fibrate
Actions: Fibric acid derivative w/ lipid-regulating properties. Lowers plasma
triglycerides by inhibiting
triglycerides synthesis and, as a result, lowers VLDL production as well as
stimulates the catabolism of
triglyceride-rich lipoprotein. Produces a moderate increase of HDL cholesterol
levels in most patients.
Peak: 6-8 hr. Half-life: 20 hr.
Indications: Hypertriglyceridemia
Norm. Dosage, Freq, Route, Range: PO 43-200 mg/day depending on product Max: 200
mg/day
Side Effects: fatigue, headache, nausea, vomiting, flatulence, constipation
Nursing Considerations: La tests: periodically monitor lipid levels, LFTs, and CBC
w/ differential, assess
for muscle pain, tenderness or weakness and if present monitor CPK level.

Drug Med Cards
1.69. Niacin
(Niacor, Niaspan)
Class: Vitamin B3; Antilipemic
Actions: produces vasodilation by direct action on vascular smooth muscles.
Inhibits hepatic synthesis
of VLDL, cholesterol, and triglyceride, and indirectly LDL.
Peak: 20-70 min. Half-life: 45 min.
Indications: Niacin deficiency, Pellagra, Hyperlipidemia
Norm. Dosage, Freq, Route, Range: PO 10-20 mg/day (Niacin Deficiency) 1.5-3g/day in
divided doses,
may increase up to 6 g/day if necessary (Hyperlipidemia) Max: 6 g/day
Side Effects: headache, tingling, flushing with sensation of warmth, bloating,
flatulence, itchy palms
Nursing Considerations: monitor therapeutic effectiveness, Lab tests: obtain
baseline and periodic blood
glucose and LFTs in patients receiving prolonged high dose therapy, monitor
diabetics, and monitor closely
for evidence of liver dysfunction

Page 33 of 75
Drug Med Cards
19. Laxatives/ Stool Softeners

1.70. Bisacodyl Suppository
(Dulcolax)
Class: Stimulant Laxative
Actions: Expands intestinal fluid volume by increasing epithelial permeability.
Induces peristaltic
contractions by direct stimulation of sensory nerve endings in the colonic wall.
Onset: PO 6-8hrs. PR 15-
60min.
Indications: Temporary relief of acute constipation and for evacuation of colon
before GI procedures.
Norm. Dosage, Freq, Route, Range: PO 5-15 mg PRN Max: 30 mg for special procedures
PR 10 mg
PRN
Side Effects: Mild cramping, nausea, vomiting, diarrhea, fluid and electrolyte
disturbances (especially
potassium and calcium)
Nursing Considerations: evaluate periodically patient’s need for continued
use of drug, add high-fiber
foods slowly to regular diet to avoid gas and diarrhea, adequate fluid intake
includes at least 6-8
glasses/day, use of laxatives results in ↓ absorption of Vitamin K
1.71. Docusate Sodium

(Colace)
Class: Stool softener
Actions: detergent action lowers surface tension, permitting water and fats to
penetrate and soften stools
for easier passage
Indications: prophylactically in patients who should avoid straining during
defecation and for treatment for
constipation
Norm. Dosage, Freq, Route, Range: PO 50-500mg/day PR 50-100mg added to enema fluid
Max:
500mg/day
Side Effects: diarrhea, nausea, bitter taste, abdominal cramps
Nursing Considerations: Withhold if diarrhea develops and notify prescriber. Take
sufficient liquid with
each dose. So not take for prolonged periods (causes slowed bowel mobility).
1.72. Lactulose
(Cephulac; Chronulac)
Class: Hyperosmotic Laxative; Neurologic
Actions: Osmotic effect on lactulose moves water from plasma to intestines,
softening stools, and
stimulates peristalsis by pressure from water content of stool.
Indications: Chronic Constipation, prevention and treatment of portal-systemic
encephalopathy (PSE)
including stages of hepatic precoma and come
Norm. Dosage, Freq, Route, Range: PO 30-60mL/day PRN Max: 60mL/day
Side Effects: diarrhea, nausea, vomiting, flatulence
Nursing Considerations: promote fluid intake (1,500-2,000mL/day or greater) during
drug therapy for
constipation
Drug Med Cards
1.73. Metoclopramide
(Metozolv, Reglan)
Class: GI Stimulant; Prokinetic agent
Actions: potent central dopamine receptor antagonist that increases resting tone of
esophageal sphincter,
and tone and amplitude of upper GI contractions. Thus gastric emptying and
intestinal transit are
accelerated. Antiemetic action results from druf-induced elevation of CTZ threshold
and enhanced gastric
emptying. Onset: 30-60 min. Peak: 1-2 hr.Duration: 1-3 hr.
Indications: GERD, Diabetic gastroparesis, Small –bowel intubation/Radiologic Exam,
Chemotherapy-
Induced Emesis, Postoperative Nausea/ Vomiting
Norm. Dosage, Freq, Route, Range: PO 10-15 mg qid before meals and at bedtime IM/IV
10 mg qid Max:
60 mg
Side Effects: mild sedation, fatigue, restlessness, diarrhea
Nursing Considerations: report S&S immediately, lab tests: periodic serum
electrolytes, monitor for
possible hypernatremia and hypokalemia, avoid alcohol and other CNS depressants,
avoid driving for a
few hours after drug admin.
1.74. Polyethylene Glycol

(Miralax)
Class: Laxatives, Osmotics
Actions: Acts as an osmotic agent, drawing water into the lumen of the GI Tract.
Peak: 2-4days
Indications: Indicated for evacuation of GI Tract w/o water or electrolyte
imbalance.
Norm. Dosage, Freq, Route, Range: 17g w/ 8oz of water
Side Effects: abdominal bloating, cramping, flatulence, nausea
Nursing Considerations: GI obstruction, gastric retention, toxic colitis,
megacolon, use cautiously in
patients w/ abdominal pain of uncertain cause, particularly if accompanied w/
fever.
1.75. Sennosides
(Senokot)
Class: Stimulant Laxative
Actions: Peristalsis stimulated by conversion of drug to active chemical. Onset: 6-
10hr; may take up to
24hr.
Indications: Acute constipation and preoperative and preradiographic bowel
evacuation
Norm. Dosage, Freq, Route, Range: PO 1-2 tabs at bedtime Max 4 tabs
Side Effects: nausea, abdominal cramps, flatulence, watery diarrhea
Nursing Considerations: Reduce dose in patients who experience considerable
abdominal cramping

Page 35 of 75
Drug Med Cards
20. Anti-Diarrheal
1.76. Diphenoxylate
(Diphenatol, Lofene, Lomanate)
Class: Antidiarrheal
Actions: reduces GI motility. Onset: 45-60 min Peak: 2hr. Duration: 3-4hr.
Indications: management of diarrhea
Norm. Dosage, Freq, Route, Range: PO 5-10mL 3-4 times daily Max: 40mL/day
Side Effects: hypersensitivity, flushing, palpitation, headache, dizziness
Nursing Considerations: Assess GI function, monitor for S&S of dehydration,
frequency and consistency
of stools
1.77. Loperamide
(Maalox, Imodium, Kaopectate, Pepto)
Class: Antidiarrheal
Actions: Inhibits GI peristaltic activity by direct action on circular and
longitudinal intestinal muscles.
Prolongs transit time of intestinal contents, increases consistency of stools, and
reduces fluid and
electrolyte loss. Onset: 30-60min. Peak: 2.5hrs (solution), 4-5hrs. (Capsules)
Duration: 4-5hrs.
Indications: Acute Diarrhea; Chronic Diarrhea
Norm. Dosage, Freq, Route, Range: PO 4mg followed by 2mg after each unformed stool
Max: 16mg/day
Side Effects: Toxic megacolon, abdominal pain or discomfort, constipation
Nursing Considerations: monitor fluid and electrolyte balance, record number and
consistency of stools

Drug Med Cards
21. Beta-Blockers
1.78. Atenolol
(Tenormin)
Class: Beta-Adrenergic Antagonist; Antihypertensive
Actions: reduces rate & force of cardiac contractions (negative inotropic action);
cardiac output is reduced
as well as systolic and diastolic BP. Decreases peripheral vascular resistance both
at rest and with
exercise. Peak: 2-4hr. Duration: 24hr. Half-life: 6-7hr.
Indications: management of hypertension as a single agent or concomitantly w/ other
antihypertensive
agents, especially a diuretic, and in treatment of stable angina pectoris, MI
Norm. Dosage, Freq, Route, Range: PO 25-50mg/day, may increase to 100mg/day Max:
100mg/day
Side Effects: Bradycardia, hypotension, CHF, pulmonary edema, nausea, vomiting
Nursing Considerations: Measure trough BP, check apical pulse before admin.,
monitor BP, monitor
diabetics for loss of glycemic control
1.79. Carvedilol
(Coreg, Coreg CR)
Class: Alpha and Beta Adrenergic Antagonist; Antihypertensive
Actions: An effective antihypertensive agent reducing BP to normotensive range and
useful in managing
some angina, dysrhythmias, and CHF by decreasing myocardial oxygen demand and
lowering cardiac
workload. Peak: Antihypertensive effect 7-14 days
Indications: CHF, Left Ventricular Dysfunction, Post MI, Hypertension
Norm. Dosage, Freq, Route, Range: PO start w/ 3.125mg bid Max: 50mg/day
Side Effects: Dizziness
Nursing Considerations: Monitor for therapeutic effectiveness, lab tests: LFTs and
digoxin levels w/
concurrent use, monitor for worsening of symptoms in patients w/ PVD
1.80. Metoprolol Tartrate

(Lopressor)
Class: Cardioselective; Beta-adrenergic antagonist; Antihypertensive; Antianginal
Actions: produces a decrease in the systolic and diastolic BPs, and reduces edema
in CHF and kidney
failure patients. Onset: 15min. Peak: PO 1.5hr. IV 20min. Duration: 13-19hr.
Indications: management of hypertension
Norm. Dosage, Freq, Route, Range: PO 50-100mg/day in 1-2 divided doses, may
increase weekly up to
100-450mg/day Max: 450mg/day
Side Effects: fatigue, insomnia, bradycardia, heartburn, shortness of breath
Nursing Considerations: Take apical pulse and BP before administering drug. Monitor
BP q12hr

Page 37 of 75
Drug Med Cards
1.81. Propanolol
(Inderal, InnoPran XL)
Class: Beta-Adrenergic Receptor Antagonist; Antihypertensive; Class II
Antiarrhythmic
Actions: Nonselective beta-blocker of both cardiac and bronchial adrenoreceptors
that competes w/
epinephrine and norepinephrine for available beta receptor sites. In higher doses,
it depresses cardiac
function including contractility and arrhythmias. Lowers both supine and standing
BP in hypertensive
patients. Peak: 60-90 min immediate release, 6 hr sustained release, IV 5 min
Indications: Hypertension, Angina, Arrhythmias, Acute MI, Migraine Prophylaxis
Norm. Dosage, Freq, Route, Range: PO 40 mg bid, usually need 160-480 mg/day Max:
480 mg/day
Side Effects: confusion, fatigue, drowsiness, bradycardia, paresthesia of hands
Nursing Considerations: Monitor apical pulse, respirations, BP and circulation to
extremities. Be aware
of adverse reactions, Lab tests: periodic hematologic, kidney, liver, and cardiac
functions, monitor I&O
1.82. Sotalol
(Betapace)
Class: Beta-Adrenergic Antagonist; Class II and III Antiarrhythmic
Actions: slows heart rate, decreases AV nodal conduction, and increases AV nodal
refractoriness.
Produces significant reduction in both systolic and diastolic blood pressure. Peak:
2-3 hr Duration: 24 hr
Indications: Ventricular Arrhythmias, Atrial Fibrillation/Flutter
Norm. Dosage, Freq, Route, Range: PO initial dose of 80 mg bid or 160 mg daily
taken prior to meals,
may increase every 3-4 days in 40-160 mg increments Max: 240 mg/day in 1-2 divided
doses
Side Effects: bradycardia, dyspnea, chest pain, palpation, fatigue, dizziness
Nursing Considerations: Monitor ECG baseline and periodically, Lab tests: baseline
serum electrolytes,
monitor cardiac status throughout therapy, monitor patients w/ bronchospastic
disease (ex: bronchitis,
emphysema) for inhibition of bronchodilation, monitor diabetics for loss of
glycemic control.

Drug Med Cards
22. Nitrates
1.83. Isosorbide Dinitrate
(Dilatrate-SR, IsoBid)
Class: Nitrate Vasodilator (prototype: Nitroglycerin)
Actions: has an anti-anginal effect as a result of vasodilation of the coronary
arteries. Onset: SL 2-5min.
w/in 1hr. reg. tabs w/in 3 min. chewable tabs 30 min. sustained release tabs
Duration: SL 1-2hr. Chewable
tabs: 1.5-2hrs. Sustained release tabs: 6-8hrs.
Indications: relief of acute anginal attacks and for management of long-term angina
pectoris
Norm. Dosage, Freq, Route, Range: 5-30mg q2-3hr. Max: 360mg/day
Side Effects: light-headedness, flushing, headache, pallor
Nursing Considerations: Monitor for effectiveness, headaches tend to decrease in
intensity and
frequency with continued use, may produce tolerance
1.84. Isosorbide Mononitrate

(Ismo, Imdur)
Class: Nitrate Vasodilator
Actions: Long acting metabolite of the coronary vasodilator isosorbide dinitrate.
It decreases preload as
measured by pulmonary capillary wedge pressure and left ventricular end volume and
diastolic pressure
with a consequent reduction in myocardial oxygen consumption. Onset: 1 hr. Peak:
regular release 30-60
min; sustained release 3-4 hr Duration: regular release 5-12 hr, sustained release
12 hr
Indications: Prevention of Angina
Norm. Dosage, Freq, Route, Range: PO regular release 20 mg bid 7 hr apart;
sustained release 30-60
mg early morning, may increase up to 120 mg after several days if needed Max: 240
mg/day
Side Effects: headache, anxiety, coughing, nasal congestion, dry mouth
Nursing Considerations: Monitor cardiac status, frequency and severity of angina
and BP, assess for
S&S for toxicity, Lab tests: monitor serum electrolytes periodically.
1.85. Nitroglycerin
(Nitro-Dur, Nitrostat, Nitroquick)
Class: Nitrate Vasodilator
Actions: Organic nitrate and potent vasodilator that relaxes vascular smooth
muscle. After conversion to
nitric oxide, it leads to dose-related dilation of both venous and arterial blood
vessels. Promotes peripheral
pooling of blood, reduction of peripheral resistance, and decreased venous return
to the heart. Both left
ventricular preload and afterload are reduced and myocardial oxygen consumption or
demand is
decreased. Onset: SL 2 min PO 3 min Ointment 30 min Duration: SL 30 min PO 3-5 hr
Ointment 3-6 hr
Indications: Angina
Norm. Dosage, Freq, Route, Range: SL 1-2 sprays (0.4-0.8 mg) or 0.3-0.6 mg tablet
q3-5min as needed
Max: 3 doses in 15 min PO 1.3-9 mg q8-12 hr Ointment apply 1.5-5 cm of ointment q4-
6hr
Side Effects: dizziness, headache, postural hypotension, Syncope, tachycardia
Nursing Considerations: Monitor BP, HR location, duration, pain

Page 39 of 75
Drug Med Cards
23. ACE-Inhibitors
1.86. Lisinopril
(Prinivil)
Class: Antihypertensive, ACE inhibitor
Actions: Lowers BP, improves cardiac output and exercise tolerance. Aldosterone is
also reduced, thus
permitting a potassium-sparing effect. Onset: 1 hr. Peak: 6-8hr. Duration: 24hrs.
Indications: Hypertension, Heart Failure
Norm. Dosage, Freq, Route, Range: (Hypertension) PO 10 mg once/day, may increase up
to 20-40 mg
1-2x/day (Heart Failure) PO 5-40 mg/day Max: 80 mg/day
Side Effects: Headache, dizziness, fatigue, hypotension, chest pain, nausea,
vomiting, diarrhea, anorexia,
constipation, intestinal angioedema, dyspnea, cough, rash, hyperkalemia, increase
BUN and creatinine
levels
Nursing Considerations: Check BP before giving med. With pt. in supine position,
monitor serum Na and
K+ levels, Lab tests: WBC q month for the first 3-6 months of therapy and at
periodic intervals for 1 yr.
1.87. Ramipril
(Altace)
Class: Angiotensin-Converting Enzyme (ACE) Inhibitor; Antihypertensive
Actions: lowers BP, and improves cardiac output as well as exercise tolerance.
Onset: 2hr Peak: 6-8hr
Duration: up to 24hr Half-life: 2-3hr
Indications:
Norm. Dosage, Freq, Route, Range: PO 2.5-5mg daily, may increase up to 20 mg/day in
1-2 divided
doses Max: 20mg/day
Side Effects:
Nursing Considerations: Monitor BP, Lab Tests: BUN and serum creatinine
periodically. Observe for
S&S of hyperkalemia

Drug Med Cards
24. Calcium Channel Blockers

1.88. Amlopidine
(Norvasc)
Class: Calcium Channel Blocker; Antihypertensive
Actions: selectively block calcium influx across cell membranes of cardiac and
vascular smooth muscle
without changing serum calcium concentrations. Peak: 6-9 hr. Duration: 24 hr.
Indications: Hypertension, Stable/Vasospastic Angina
Norm. Dosage, Freq, Route, Range: PO 5-10 mg once daily Max: 10 mg
Side Effects: peripheral and facial edema, headache
Nursing Considerations: Monitor BP & HR, monitor for S&S of peripheral and facial
edema, monitor BP
with postural changes

Page 41 of 75
Drug Med Cards
25. Central Acting Antihypertensive

1.89. Clonidine
(Catapres)
Class: Central-Acting Antihypertensive; Analgesic
Actions: Decreases systolic and diastolic BP and HR. Reportedly minimizes or
eliminates many of the
common clinical S&S associated w/ withdrawal of heroin, methadone, or other
opiates. Onset: PO 30-
60min. Peak: PO 2-4hr. Duration: PO 8hr.
Indications: Hypertension, ADHD, Severe Pain
Norm. Dosage, Freq, Route, Range: PO 0.1mg Max: 2.4mg/day
Side Effects: Hypotension, dry mouth, drowsiness, sedation, constipation
Nursing Considerations: Monitor BP closely, monitor I&O during period of dosage
adjustment
1.90. Guanfacine HCL

(Intuniv, Tenex)
Class: Alpha-Adrenergic Agonist; Central-Acting Antihypertensive
Actions: In cerebral cortex, stimulation of alpha2-adrenoreceptors triggers
inhibitory neurons to reduce
central sympathetic outflow (ie., impulses from vasomotor center to heart * blood
vessels) Onset: 2hr.; 6hr.
ER Peak: 6hr. Duration: Up to 24hr.
Indications: Hypertension; Attention Deficit Hyperactivity Disorder (ADHD)
Norm. Dosage, Freq, Route, Range: PO 1mg/day titrate up (Normal range: 1-4mg/day)
Side Effects: dizziness, sedation, fatigue, dry mouth, constipation, impotence
Nursing Considerations: do not d/c abruptly, may cause plasma & urinary
catecholamine increases
leading symptoms of tachycardia, insomnia, anxiety, nervousness; monitor BP until
stabilized; assess
mental status & alertness; employ measure to keep mouth moist; avoid alcohol & do
not self-medicate w/
OTC drugs

Drug Med Cards
26. Antihypertensives
1.91. Losartan
(Cozaar)
Class: Angiotensin II Receptor Antagonist; Antihypertensive
Actions: Antihypertensive effect is due to vasodilation and inhibition of
aldosterone effects on sodium and
water retention. Peak: 6hr. Duration 24hr.
Indications: Hypertension
Norm. Dosage, Freq, Route, Range: PO 25-52mg in 1-2 divided doses Max: 100mg/day
Side Effects: dizziness, dyspepsia, insomnia, headache
Nursing Considerations: Monitor BP at drug trough, lab tests: monitor CBC,
electrolytes, liver and kidney
functions w/ long-term therapy
1.92. Valsartan
(Diovan)
Class: Renin Angiotensin System Antagonist; Antihypertensive
Actions: Blocks angiotensin II receptors results in vasodilation as well as
decreasing the aldosterone-
secreting effects of angiotensin II. These actions result in the antihypertensive
effect of valsartan. Onset:
BP decreased in 2 weeks. Peak: Plasma levels, 2-4hr; BP effect 4 weeks
Indications: Hypertension, Heart Failure
Norm. Dosage, Freq, Route, Range: PO 40-80mg daily Max: 320mg/day
Side Effects: headache, dizziness, nausea, vomiting
Nursing Considerations: monitor BP, lab tests: periodic LFTs, BUM, and creatinine,
serum potassium,
and CNC w/ differential
1.93. Terazosin
(Prazosin)
Class: Alpha-Adrenergic Receptor Antagonist, Antihypertensive
Actions: Selectively blocks Alpha1-adrenergic receptors in vascular smooth muscle
in many tissues,
including vascular smooth muscle, the bladder neck, and the prostate. Promotes
vasodilation, thus
producing relaxation that leads to reduction of peripheral vascular resistance and
lowers BP as well as
increased urine flow. Peak: 1-2 hr.
Indications: Hypertension, Benign Prostatic Hypertrophy
Norm. Dosage, Freq, Route, Range: PO start with 1 mg at bedtime, then 1-5 mg/day
Max: 20 mg/day
Side Effects: Asthenia (weakness), dizziness, headache, 1st –dose phenomenon
syncope
Nursing Considerations: Monitor BP, be alert for possible 1st –dose phenomenon

Page 43 of 75
Drug Med Cards
27. Antipsychotics
1.94. Aripiprazole
(Abilify)
Class: Atypical Antipsychotic; Dopamine System Stabilizer
Actions: combination of partial agonist activity at D2 and 5-HT1A receptors and
antagonists activity at 5-
HT2A receptors. Peak: 3-5hrs.
Indications: Schizpphrenia; Bipolar Mania; Agitation associated w/
Schizophrenia/Bipolar; Adjunct in Major
Depression; Irritability associated w/ Autism
Norm. Dosage, Freq, Route, Range: PO 10-15mg once daily, may increase at 2wk
intervals to Max:
30mg/day
Side Effects: headache, insomnia, light-headedness, somnolence, akathisia, risk of
stroke in elderly w/
dementia-related-psychosis, N&V, constipation
Nursing Considerations: monitor cardiovascular status, Lab tests: periodic Hct and
Hbg, and blood
glucose, monitor for elevated CPK and myoglobinuria if NMS is suspected.
1.95. Asenapine
(Saphris)
Class: Atypical Antipsychotic; Serotonin Antagonist; Antimanic; Antidepressant
Actions: thought to be related to antagonism to certain CND dopamine (D2) and
serotonin (5-HT2a)
receptors. Peak: 0.5-1.5hr.
Indications: Schizophrenia; Bipolar Disorder
Norm. Dosage, Freq, Route, Range: SL 5mg bid
Side Effects: Extrapyramidal symptoms (EPS), headache, somnolence, insomnia
Nursing Considerations: monitor BP, HR, and weight; monitor for orthostatic
hypotension; monitor
diabetes
1.96. Atomoxetine
(Strattera)
Class: Miscellaneous Psychotherapeutic
Actions: Selective inhibition of the presynaptic norepinephrine transporter,
resulting in norepinephrine
reuptake inhibition. Peak: 1-2hr.
Indications: Attention Deficit Hyperactivity Disorder (ADHD)
Norm. Dosage, Freq, Route, Range: PO start w/ 40mg in a.m., may increase after 3
days to target dose
of 80mg/day given either in a.m. or divided dose. May increase to 100mg/day if
needed.
Side Effects: headache, insomnia, suicidal ideation, upper abdominal pain, nausea,
vomiting, decreased
appetite, severe liver failure, and cough
Nursing Considerations: evaluate therapeutic effectiveness; report increased
aggression & irritability as
there may indicate need to d/c the drug; monitor children & adolescence for
behavior changes that may
indicate suicidal ideation; monitor cardiovascular status especially w/ preexisting
hypertension; monitor HR
& BP at baseline, following a dose increase, and periodically during therapy; Lab
tests: periodic LFTs
Drug Med Cards
1.97. Chlorpromazine
(Thorazine)
Class: Antipsychotic; Phenothiazine; Antiemetic
Actions: mechanism thought to be related to blockade of post-synaptic dopamine
receptors in the brain.
Onset: 30-60min. Peak: PO 2-4hr. IM 15-20min. Duration: 4-6hr.
Indications: Psychotic disorder, agitation; nausea and vomiting; dementia;
intractable hiccups; tetanus
Norm. Dosage, Freq, Route, Range: PO 25-100mg tid or qid, Max: 1,000mg/day IM/IV:
25-50mg Max:
600mg
Side Effects: Agranulocytosis,Neuroleptic malignant syndrome (NMS),
hypothermia,adynamic ileus,
sedation, extrapyramidal symptoms (EPS)
Nursing Considerations: Lab tests: LFTs, periodic CBC w/ diff, and blood glucose,
monitor cardiac status,
be alert for NMS and report immediately, report EPS, monitor BP frequently, may
cause pink to red-brown
discoloration of urine, have pt. wear protective clothing and sunscreen when
outdoors, have pt. practice
meticulous oral hygiene to prevent oral candidiasis
1.98. Clozapine
(Clozaril)
Class: Atypical Antipsychotic
Actions: Interferes w/ binding of dopamine to D1 and D2 receptors in the limbic
region of the brain. Onset:
2-4 wk. Peak: 2.5 hr.
Indications: Schizophrenia
Norm. Dosage, Freq, Route, Range: PO initiate 12.5mg daily or bid and increase by
25-50mg/day and
titrate to a target of 350-400mg/day in 3 divided doses Max: 900mg/day
Side Effects: tachycardia, agranulocytosis, transient fever, neuroleptic malignant
syndrome (NMS),
increased mortality from severe hematologic, cardiovascular, and respiratory
adverse effects.
Nursing Considerations: Lab tests: baseline WBC and absolute neutrophil count must
be made before
initial treatment q wk. for first 6 mon. then q2wk.for the next 6 mon. then
q4wk.periodic blood glucose,
monitor cardiovascular and respiratory status,
1.99. Fluphenazine HCL

(Prolixin)
Class: Antipsychotic; Phenothiazine
Actions: thought to be related to blockade of post-synaptic dopamine receptors in
the brain. Onset: 1hr.
Peak: 0.5hr. Duration: 6-8hr.
Indications: Psychosis; Dementia Behavior
Norm. Dosage, Freq, Route, Range: PO 0.5-10mg/day in 1-4 divided doses Max:
20mg/day
Side Effects: extrapyramidal symptoms (EPS), tardive dyskinesia, impaired
thermoregulation, leukopenia,
agranulocytosis, photosensitivity
Nursing Considerations: report any EPS or mental depression, Lab tests: periodic
WBC w/ diff, LFTs,
monitor renal function and notify prescriber if BUN is elevated, have pt. wear
protective clothing and
sunscreen when outdoors, may discolor urine pink to red or reddish brown

Page 45 of 75
Drug Med Cards
1.100. Haloperidol
(Haldol)
Class: Antipsychotic, Butyrophenone
Actions: Blocks postsynaptic dopamine receptors in the limbic system
of the brain. ↓ in dopamine
neurotransmission has been correlated w/ its higher instance of
extrapyramidal effects. ↓ Psychotic
manifestations & exerts strong antiemetic effect. Onset: IM 30-45min. Peak: PO 2-
6hr., IM 10-20min.
Indications: Management of manifestations of psychotic disorders & for control of
tics & vocal utterances
of Tourette’s syndrome, for treatment of agitated state is acute and
chronic psychoses.
Norm. Dosage, Freq, Route, Range: PO 0.2-5 mg bid or tid Max: 15 mg.day
IM 2-5 mg q4hr PRN Max: 30 mg/day
Side Effects: extrapyramidal reactions, tardive dyskinesia, agitation, drowsiness,
lethargy, fatigue, tremor,
ataxia, headache, confusion, vertigo, tachycardia
Nursing Considerations: monitor for drug effectiveness (long half-life), monitor
patients’ mental status
daily, be alert for behavioral changes
1.101. Iloperidone
(Fanapt)
Actions: is both a dopamine (D2) and serotonin (5-HT2) antagonist. Peak: 2-4hr.
Norm. Dosage, Freq, Route, Range: PO initial 1mg big, then titrated to 6-12mg bid
Side Effects: dizziness, somnolence, tachycardia
Nursing Considerations: monitor for suicidal ideation, monitor BP, HR, and weight,
monitor for orthostatic
hypotension, Lab tests: baseline and periodic CBC w/ diff
1.102. Lithium Carbonate

(Eskalith, Lithane, Lithobid, Lithonate, Lithotabs)
Class: Antipsychotic; Mood Stabilizer
Actions: The lithium ions behaves in the body much like the sodium ion: but its
exact mechanism of action
is unclear. Peak: 0.5-3hrs.
Indications: Mania
Norm. Dosage, Freq, Route, Range: PO: Loading Dose 600mg tid or 900mg sustained
release bid or
30mL of solution tid PO: Maintenance Dose 300mg tid or qid or 15-20mL solution in
2-4 divided dose Max:
2.4g/day
Side Effects: headache, lethargy fatigue, recent memory loss, peripheral
circulatory collapse, nephrogenic
diabetes insipidus, nausea, vomiting, anorexia, abdominal pain, diarrhea, dry
mouth, fine, hand tremors,
muscle weakness, reversible leukocytosis
Nursing Considerations: Lab tests: periodic lithium levels; periodic thyroid
function tests; monitor for S&S
of lithium toxicity; be alert to and report symptoms of hypothyroidism; drink
plenty of liquids (2-3L/day)during
stabilization and at least (1-1.5L/day) during ongoing therapy
Drug Med Cards
1.103. Lurasidone
(Latuda)
Actions: the mechanism of action is unknown but the efficacy of lurasidone in
schizophrenia is thought to
be mediated through central dopamine type 2 (D2) and serotonin Type 2 (5HT2a)
receptor antagonism.
Norm. Dosage, Freq, Route, Range: PO 40-160mg one daily
Side Effects: akathisia, dizziness, somnolence, parkinsonism, nausea
Nursing Considerations: monitor orthostatic VS, Lab tests: periodic blood glucose,
lipid profile, LFTs,
and CBC w/ diff, monitor closely pts. w/ neutropenia, monitor weight, monitor for
and report promptly seizure
activity, S&S of Neuroleptic Malignant Syndrome (NMS) or tardive dyskinesia
1.104. Olanzapine
(Zyprexa)
Actions: thought to be due to antagonism for both serotonin 5-HT2A/2C and dopamine
D1-4 receptors.
Peak: 6hr.
Indications: Psychotic disorders; Bipolar Mania; Acute Agitation
Norm. Dosage, Freq, Route, Range: PO start w/ 5-10mg/day, may increase by 2.5-5mg q
wk. until desired
response Max: 20mg/day
Side Effects: weight gain, somnolence, dizziness, agitation, insomnia, headache,
nervousness, hostility,
Parkinsonism
Nursing Considerations: monitor cerebrovascular status closely, Lab tests:
periodically monitor ALT,
blood glucose, monitor BP and HR periodically and monitor temp.
1.105. Paliperidone
(Invega)
Actions: Interferes w/ binding of dopamine to dopamine type 2 (D2) receptors,
serotonin (5-HT2a)
receptors and alpha-adrenergic receptors. Peak: 24hrs
Indications: Schizophrenia; Schizoaffective Disorder
Norm. Dosage, Freq, Route, Range: PO initially 6mg/day, may adjust up/down in 3mg
increments Max:
12mg/day
Side Effects: Akathisia, headache, somnolence
Nursing Considerations: Baseline ECG is recommended to rule out congenital long-QT
syndrome; Lab
tests: baseline and periodic serum electrolytes, periodic blood glucose, and CBC;
monitor diabetes and
loss of glycemic control

Page 47 of 75
Drug Med Cards
1.106. Prochlorperazine Meleate

(Compazine)
Class: Antipsychotic; Phenothiazine, Antiemetic
Actions: Strong antipsychotic effects thought to be due to blockade of postsynaptic
dopamine receptors
in the brain. Antiemetic effect is produced by suppression of the chemoreceptor
trigger zone (CTZ). Onset:
PO 30-40 min, PR 60 min, IM 10-20 min Duration: PO 3-4 hr, Sustained Release PO 10-
12 hr, PR 3-4 hr,
IM up to 12 hr
Indications: Severe Nausea/Vomiting, Psychotic Disorders
Norm. Dosage, Freq, Route, Range: PO 5-10 mg 3-4 times/day, Sustained Release PO
10-15 mg q 12
hr PR 25 mg bid IM 5-10 mg q3-4hr up to 40 mg/day IV 2.5-10 mg q3-4hr Max: 40
mg/day
Side Effects: drowsiness, extrapyramidal reactions (akathisia, dystonia or
parkinsonism)
Nursing Considerations: position carefully to prevent aspiration, Lab tests:
periodic CBC with diff in long-
term therapy, be alert of high core temperature
1.107. Quetiapine
(Seroquel)
Actions: effectiveness indicated to a reduction in psychotic behavior. Peak: 1.5hr.
Half-life: 6hrs.
Indications: management of schizophrenia, maintenance of acute bipolar disorder,
and add-on therapy
for major depressive disorder
Norm. Dosage, Freq, Route, Range: 25-50mg dose and increase by 25-50mg/day Max:
800mg/day
Side Effects: dizziness, headache, somnolence, leukopenia
Nursing Considerations: Monitor for respiratory depression in patients with chronic
respiratory
insufficiency and suicidal tendencies
1.108. Risperidone
(Risperdol)
Actions: interferes w/ binding of dopamine to D2-interlimbic region of the brain,
serotonin (5-HT2)
receptors, and alpha-adrenergic receptors in the occipital cortex. Onset:
therapeutic effect 1-2 wk. Peak: 1-
2hr.
Indications: Schizophrenia; Bipolar Disorder; Irritability Associated w/ Autism
Norm. Dosage, Freq, Route, Range: PO 1-2mg/day in 1 or 2 doses then titrate up Max:
8mg/day
Side Effects: sedation, drowsiness, headache, insomnia, agitation, extrapyramidal
symptoms (EPS),
neuroleptic malignant syndrome (NMS)
Nursing Considerations: monitor cardiovascular status closely, Lab tests: monitor
periodically blood
glucose, serum electrolytes, LFTs, and CBC, be aware of risk for orthostatic
hypotension
Drug Med Cards
1.109. Thioridazine HCL

(Mellaril)
Actions: blocks post-synaptic dopamine receptors in the mesolimbic system of the
brain. Onset: days to
weeks
Indications: Psychotic disorders; moderate to marked depression; dementia behavior
Side Effects: sedation, paralytic ileus, urinary retention
Nursing Considerations: monitor I&O ratio and bowel elimination pattern,
orthostatic hypotension may
occur, Lab tests: obtain periodic CBC and LFTs during therapy, avoid alcohol, may
cause pink-red to
reddish-brown urine
1.110. Trifluoperazine HCL

(Stelazine)
Actions: thought to be related to blockade of post-synaptic dopamine receptors in
the brain. Onset: Rapid
Peak: 2-3hr. Duration: up to 12hr.
Indications: Schizophrenia; Anxiety
Norm. Dosage, Freq, Route, Range: PO 1-2mg bid Max: 20mg/day
Side Effects: drowsiness, extrapyramidal symptoms (EPS), neuroleptic malignant
syndrome (NMS), dry
mouth, hypotension
Nursing Considerations: monitor HR and BP, monitor I&O ratio and bowel elimination
pattern, Lab tests:
periodic CBC and serum prolactin, cover as much skin surface as possible with
clothing when you must be
in direct sunlight, urine may be discolored or reddish-brown
1.111. Ziprasidone HCL

(Geodon)
Actions: exerts antischizophrenic effects through dopamine (D2) and serotonin (5-
HT2a) receptors
antagonism. Peak: 6-8hrs.
Indications: Schizophrenia; Acute episodes of Agitation/Acute psychosis, Acute
Mania/Bipolar Disorder
Norm. Dosage, Freq, Route, Range: PO start w/ 20mg bid w/ food, may increase q2days
up to 80mg bid
if needed Max: 160mg/day
Side Effects: somnolence, nausea
Nursing Considerations: Lab tests: baseline and periodic ECGs, serum potassium and
serum
magnesium, periodically monitor blood glucose, monitor I&O ratio and pattern,
monitor BP, monitor
cognitive status, monitor for loss of seizure control, avoid strenuous exercise,
exposure to extreme heat, or
other activities that may cause dehydration

Page 49 of 75
Drug Med Cards
28. Anti-Coagulants
1.112. Enoxaparin
(Lovenox)
Class: Anticoagulant; Low Molecular Weight Heparin
Actions: An effective anticoagulation agent, if is used for prophylactic treatment
as an antithrombotic agent
following certain types of surgery. Peak: 3 hr. Duration 4-6 hr.
Indications: Prevention of DVT after Hip or Knee Surgery, Prevention of DVT after
Abdominal Surgery,
Treatment of DVT and Pulmonary Embolus, Non-Q Wave MI Acute STEMI
Norm. Dosage, Freq, Route, Range: SQ 30 mg bid for 10-14 days starting 12-24 hr
post-surgery Max:
60 mg/day
Side Effects: Dyskinesia, Hyperkinesia, Nausea, Diarrhea, Urine discoloration
Nursing Considerations: Monitor carefully for hyperpyrexia, confusion, or
emergence of Parkinson’s S&S
during drug w/drawal, monitor for orthostatic hypotension and worsening of
dyskinesia, or hyperkinesia,
Lab tests: Hgb and serum ferritin levels w/ prolonged therapy
1.113. Heparin
(Heparin Sodium)
Class: Anticoagulant
Actions: Has rapid anticoagulant effect, does not lyse already existing thrombi but
may prevent their
extension & propagation. Onset: SQ 20-60min. Peak: in min. Duration: SQ 8-12hr. IV
2-6hr.
Indications: prophylaxis and treatment of venous thrombosis and pulmonary embolism
& to prevent
thromboembolic complications arising from cardiac & vascular surgery, frostbite, &
curing acute stage of
MI
Norm. Dosage, Freq, Route, Range: IV 5,000 units bolus dose then 20,000-40,000
units infused over
24hr, dose adjusted to maintain desired aPTT or 5,000-10,000 units IV piggyback q4-
6 hr Max: 60,000
units/day SQ 10,000-20,000 units/m2/24hr
Side Effects: spontaneous bleeding, fever, chills, numbness, elevated BP, headache
Nursing Considerations: Lab tests: baseline blood coag., Hct, Hgb, RBC, & platelet
count prior to admin.,
monitor aPTT levels closely, blood draw for coag. test 30 min before each scheduled
SQ or intermittent IV
dose, observe all needle sites daily, monitor vital signs

Drug Med Cards
29. Antiplatelets
1.114. Aspirin
(ASA)
Class: Non-narcotic, Antiplatelet, Antipyretic
Actions: inhibiting the formation of prostaglandins involved in the production of
inflammation, pain and
fever, powerfully inhibits platelet aggregation. High serum salicylate
concentrations can impair hepatic
synthesis of blood coagulation factors VII, IX, X. Peak: 15min-2hr.
Indications: Anti-inflammatory action, pain, fever reducer, antiplatelet
Norm. Dosage, Freq, Route, Range: PO: 350-650 mg q4h Max: 4 g/day
Side Effects: Bronchospasm, anaphylactic shock (laryngeal edema), nausea,
heartburn, stomach pains,
thrombocytopenia, hemolytic anemia
Nursing Considerations: Allergy to any ASA, monitor for salicylate toxicity. In
adults, a sensation of
fullness in the ears, tinnitus, and decreased or muffled hearing are the most
frequent symptoms.
1.115. Clopidogrel
(Plavix)
Class: Antiplatelet
Actions: prolongs bleeding time, thereby reducing atherosclerotic events in high-
risk patients. Onset: 2hr.
reaches steady state in 3-7 days Half-life: 8hr.
Indications: acute coronary syndrome (ST or non-ST elevations). Secondary of MI,
stroke, and vascular
death
Norm. Dosage, Freq, Route, Range: PO 75mg/day Max: 75mg/day
Side Effects: fatigue, back pain, diarrhea, nausea, headache, dizziness
Nursing Considerations: Monitor for S&S of GI bleeding. Lab tests: platelet count,
and lipid profile
1.116. Dipyridamole
(Apo-Dipyridamole)
Class: Antiplatelet; Platelet Aggregate Inhibitor
Actions: Nonnitrate coronary vasodilator that increase coronary blood flow by
selectively dilating coronary
arteries, thereby increasing myocardial oxygen supply. Peak: 45-150 min.
Indications: Prevention of thromboembolism in cardiac valve replacement,
Thromboembolic Disorders,
Thallium Stress Test
Norm. Dosage, Freq, Route, Range: PO 150-400 mg/day in divided doses Max: 400
mg/day
Side Effects: headache, dizziness, faintness, syncope, weakness
Nursing Considerations: monitor therapeutic effectiveness

Page 51 of 75
Drug Med Cards
30. Proton Pump Inhibitor

1.117. Omeprazole
(Prilosec, Prilosec OTC)
Class: Proton Pump Inhibitor (PPI); Antisecretory
Actions: Suppresses gastric acid secretion relieving gastrointestinal distress and
promoting ulcer healing.
Onset: 0.5-3.5hr. Peak: 5 days
Indications: GERD, Duodenal Ulcer, Erosive Esophagitis, Hyper secretory disease,
gastric ulcer
Norm. Dosage, Freq, Route, Range: PO 20-40mg once/day for 4-8 weeks Max: 360mg/day
Side Effects: headache, dizziness, fatigue, diarrhea, abdominal pain, nausea
Nursing Considerations: Lab tests: monitor urinalysis for hematuria and
proteinuria, periodic LFTs w/
prolonged use.
1.118. Pantoprazole
(Protonix)
Class: Gastric Proton Pump Inhibitor; Antisecretory
Actions: suppresses gastic acid secretion by inhibiting the acid (proton H+) pump
in the parietal cells.
Peak: 2-4hrs.
Indications: short-term treatment of erosive esophagitis associated w/
gastroesphageal reflux disease
(GERD), hyper secretory
Norm. Dosage, Freq, Route, Range: PO 40mg daily for 7-10days Max: 40mg/day
Side Effects: diarrhea, flatulence, abdominal pain, headache, insomnia, rash
Nursing Considerations: Lab tests: Urea breath test 4-6 wks after completion of
therapy. Monitor for
severe skin reaction

Drug Med Cards
31. H2- Receptor Antagonist

1.119. Famotidine
(Pepcid)
Class: Antisecretory (H2-Receptor Antagonist)
Actions: reduces parietal cell output if hydrochloric acid; thus, detrimental
effects of acid on gastric mucosa
are diminished. Onset: 1hr Peak: 1-3hr Duration: 10-12hr
Indications: short-term treatment of active duodenal ulcer, GERD, gastritis
Norm. Dosage, Freq, Route, Range: PO 40mg at bedtime or 20mg bid IV 20 mg q12hr.
Max: 40mg/day
Side Effects: dizziness, headache, confusion, depression, constipation, diarrhea
Nursing Considerations: Monitor for improvement in GI distress. Monitor for signs
of GI bleeding. Be
aware that pain relief may not be experience for several days.

Page 53 of 75
Drug Med Cards
32. Cerebral Stimulant

1.120. Amphetamine Sulfate
(Adderall)
Class: Cerebral Stimulant; Anorexiant
Actions: Marked stimulant effect on CNS thought to be due to action on cerebral
cortex & possibly the
reticular activating system. Acts indirectly on adrenergic receptors by increasing
synaptic release of
norepinephrine in the brain & by blocking reuptake of norepinephrine at the
presynaptic membrane. Peak:
1-5hr. Duration: Up to 10hr.
Indications: Narcolepsy; Attention Deficit Disorder (ADD)
Norm. Dosage, Freq, Route, Range: PO 10mg ER once daily in a.m.; may increase by 5-
10mg at weekly
intervals if need to max of 30mg/day
Side Effects: Sudden death; irritability; restlessness; insomnia; euphoria;
palpitation
Nursing Considerations: Monitor S&S of toxicity in children; monitor for S&S of
insomnia or anorexia;
monitor BP & HR; monitor diabetic closely; monitor growth in children; meticulous
oral hygiene is required
because of decreased saliva; rinse mouth frequently with clear water; avoid
caffeine-containing beverages
because caffeine increase amphetamine effects; taper drug on withdrawal
1.121. Methylphenidate HCL

(Ritalin, Focalin, Concerta)
Class: Cerebral Stimulant
Actions: Acts mainly on cerebral cortex exerting stimulant effect. Peak: 1.9hr. 4-
7hr. sustained release,
2hr. transdermal Duration: 3-6hr., 8 hr. sustained release
Indications: Narcolepsy; Attention Deficit Disorder (ADD)
Norm. Dosage, Freq, Route, Range: PO immediate release products 20-30mg/day in
divided doses
Concerta extended release 18-36mg/day
Side Effects: nervousness, insomnia, exfoliative dermatitis
Nursing Considerations: Monitor BP & pulse at appropriate intervals; Lab tests:
obtain periodic CBC w/
diff & platelet counts during prolonged therapy; monitor closely pt. w/ history of
alcoholism; supervise drug
withdrawal; check weight at least 2-3 times weekly & report weight loss; check
height & weight in children,
failure to gain in either should be reported to prescriber; w/hold patch from an
ADHD child who exhibits
anxiety, tension, or agitation & consult prescriber

Drug Med Cards
33. Antihistamines
1.122. Diphenhydramine
(Benadryl)
Class: Centrally acting cholinergic antagonist, Antihistamine, h1-receptor
antagonist
Actions: suppresses central cholinergic activity and prolongs action of dopamine by
inhibiting its reuptake
and storage. Onset: 15-30 min. Peak: 1-4hr. Duration: 4-7hr.
Indications: temporary symptomatic relief of various allergic conditions and to
treat or prevent motion
sickness, vertigo, and reactions to blood or plasma in susceptible patients
Norm. Dosage, Freq, Route, Range: PO 25-50mg tid or qid Max: 300mg/day IV/IM 10-
50mg q4-6hr Max:
400mg/day
Side Effects: drowsiness, tachycardia, dry mouth
Nursing Considerations: supervise ambulation, monitor cardiovascular status, do not
use with alcohol
and other CNS depressants, increase fluid intake
1.123. Hydroxyzine HCL

(Atarax)
Class: Antihistamine, H1-receptor antagonist
Actions: H1 receptor antagonist blocks histamine. Onset: PO 15-30min. Duration: 4-
6hrs.
Indications: Anxiety; Pruritus; Nausea
Norm. Dosage, Freq, Route, Range: PO 50-100mg tid IM 50-100mg q4-6hrs.
Side Effects: drowsiness, dizziness, headache, hypotension, urticarial, dyspnea,
chest tightness,
wheezing, involuntary motor activity
Nursing Considerations: reduce if CNS depressants are prescribed concomitantly,
monitor oral
membranes, alertness and drowsiness
1.124. Hydroxyzine Pamoate

(Vistaril)
Class: Antihistamine, H1-receptor antagonist
Actions: H1 receptor antagonist blocks histamine. Onset: PO 15-30min. Duration: 4-
6hrs.
Indications: Anxiety; Pruritus; Nausea
Norm. Dosage, Freq, Route, Range: PO 50-100mg tid IM 50-100mg q4-6hrs.
Side Effects: drowsiness, dizziness, headache, hypotension, urticarial, dyspnea,
chest tightness,
wheezing, involuntary motor activity
Nursing Considerations: reduce if CNS depressants are prescribed concomitantly,
monitor oral
membranes, alertness and drowsiness

Page 55 of 75
Drug Med Cards
1.125. Promethazine
(Phenergan)
Class: Antihistamine, Antiemetic, Antivertigo
Actions: Long-acting derivative of phenothiazine with marked antihistamine activity
and prominent
sedative, amnesic, and anti-motion sickness actions. Onset: PO/PR/IM 20 min IV 5
min Duration: 2-8 hr
Indications: Motion sickness, nausea, pruritus sedation
Norm. Dosage, Freq, Route, Range: PO/PR 25mg q12hr Max: 50mg
Side Effects: drowsiness, blurred vision, dry mouth
Nursing Considerations: supervise ambulation, monitor respiratory function, drug
may suppress cough
reflex and cause thickening of bronchial secretions

Drug Med Cards
34. Antidiabetic
1.126. Glipizide
(Glucotrol)
Class: Antidiabetic, Sulfonylurea
Actions: It lowers blood glucose level by stimulating pancreatic beta cells.
Glipizide improves postprandial
glycemic control. Onset: 15-30 min. Peak: 1-2 hr. Duration up to 24 hr.
Indications: Adjunct to diet for control of hyperglycemia in patient with type 2
diabetes mellitus.
Norm. Dosage, Freq, Route, Range: PO: 2.5-5 mg/day 30 min. before breakfast, may
increase by 2.5-5
mg q1-2 wk; greater than 15mg/day in divided doses before morning and evening meals
Max: 40 mg/day
Side Effects: hypoglycemia, anorexia, nausea, epigastric discomfort, heartburn,
diarrhea, allergic skin
reactions
Nursing Considerations: Observe for early signs of hypoglycemia, lab tests: monitor
fasting and
postprandial blood glucose, and periodic HgbA1C, LFTs, electrolytes and serum
osmolarity, must be made
aware of the potential for hypoglycemia responses.
1.127. Glyburide
(DiaBeta, Glynase)
Class: Antidiabetic; Sulfonylurea
Actions: One of the most potent of the 2nd generation sulfonylurea hypoglycemic
agents. Appears to lower
blood sugar concentration in both diabetic and nondiabetic individuals by
sensitizing pancreatic beta cells
to release insulin in the presence of elevated serum glucose levels. Onset: 15-
60min. Peak: 1-2hr.
Duration: up to 24hr. Half-life: 10hr.
Indications: adjunct to diet and exercise to lower blood glucose in patients with
type 2 diabetes mellitus.
Norm. Dosage, Freq, Route, Range: PO 1.25mg-5mg/day, may increase by 2.5-5mg q1-
2wk; greater
than 15mg/day should be given in divided doses with morning and evening meal Max:
20mg/day
Side Effects: hypoglycemia, nausea, vomiting, blurred vision
Nursing Considerations: Monitor blood glucose levels carefully, monitor at regular
intervals: Fasting and
postprandial blood glucose, HbA1C, and LFTs.
1.128. Insulin (Regular)

(Humulin R, Novolin R)
Class: Antidiabetic, short-acting insulin
Actions: Lowers blood glucose levels by increasing peripheral glucose uptake and by
inhibiting the liver
from changing glycogen to glucose. Onset: 0.5-1hr. Peak: 2-4hr. Duration: 5-7hrs.
Indications: Emergency treatment of diabetic ketoacidosis or coma, to initiate
therapy in patient w/ insulin-
dependent diabetes, an in combo w/ inter.-acting or long-acting insulin to provide
better control of blood
glucose concentration.
Norm. Dosage, Freq, Route, Range: SQ 5-10 units 30-60 min a.c and at bedtime (dose
adjustments
based on blood glucose determinations)
Side Effects: hypoglycemia, nausea, palpitation, profuse sweating, hunger,
tremulousness, weakness,
fatigue, numb mouth and tongue
Nursing Considerations: lab tests: periodically monitor fasting and postprandial
blood glucose and
HbA1C, test urine for ketones in new, unstable & Type 1 diabetes, if patient lost
weight, exercises

Page 57 of 75
Drug Med Cards
vigorously, or has an illness, whenever blood glucose is substantially elevated

(Onset: 0.5-1 hr. Peak: 2-4
hr. Duration: 5-8 hr.)
1.129. Insulin (NPH)

(Humulin N, Novolin N)
Class: Antidiabetic, Intermediate-acting insulin
Actions: Controls post-pyramidal hyperglycemia, usually w/o supplemental doses of
insulin injection.
Onset: 1-2hr. Peak: 4-12hrs. Duration: 18-24hrs.
Indications: Used to control hyperglycemia in the diabetic patient.
Norm. Dosage, Freq, Route, Range: SQ 5-10 units 30-60 min a.c and at bedtime (dose
adjustments
based on blood glucose determinations)
Side Effects: hypoglycemia, nausea, palpitation, profuse sweating, hunger,
tremulousness, weakness,
fatigue, numb mouth and tongue
Nursing Considerations: lab tests: periodically monitor fasting and postprandial
blood glucose and
HbA1C, test urine for ketones in new, unstable and Type 1 diabetes, if patient lost
weight, exercises
vigorously, or has an illness, whenever blood glucose is substantially elevated
(Onset: 1-2 hr. Peak: 4-12
hr. Duration: 10-18hr.)
1.130. Insulin Detemir

(Levemir)
Class: Antidiabetic; Long-acting insulin
Actions: effective as a glucose-lowering agent, w/ glycemic control equivalent to
that of NPH insulin. Peak:
6-8hrs.
Indications: treatment of diabetes mellitus
Norm. Dosage, Freq, Route, Range: SQ 0.1-0.2units/kg daily in evening or 10units
daily or bid in evenly
spaced doses
Side Effects: hypoglycemia, weight gain, allergic reactions, rash
Nursing Considerations: Monitor for S&S of hypoglycemia. Periodic fasting blood
glucose and HbA1C,
serum potassium with concurrent potassium-lowering drugs
1.131. Insulin Glargine

(Lantus)
Class: Antidiabetic long-acting insulin
Actions: Lowers blood glucose levels over an extended period of time. It also
prevents the conversion of
glucagon to glucose in the liver. Onset: 3-4hrs. Duration: 10.4-24hrs.
Indications: Bedtime dosing of adults and children w/ type 1 diabetes, or adults w/
type 2 diabetes
Norm. Dosage, Freq, Route, Range: SQ for Type 1: if not taking insulin, give 10
units at same time each
day (usually at bedtime) once daily, adjust based on patient need and concurrent
medication SQ Type 2: if
already taking oral hypoglycemic drugs, start w/ 10 units at same time each day
(usually at bedtime) once
daily and adjust according to patient’s need
Side Effects: hypoglycemia, hypokalemia, injection site reaction
Nursing Considerations: monitor for S&S of hypoglycemia, lab tests: periodically
monitor fasting and
postprandial blood glucose and HbA1C (Onset: 2-8 hr. Peak: none Duration: 5-24 hr.)

Drug Med Cards
1.132. Insulin Lispro

(Humalog)
Class: Antidiabetic; Rapid-Acting Insulin
Actions: It lowers blood glucose levels and inhibits liver from changing glycogen
to glucose. Onset: less
than 15 minutes Peak: 0.5-1hr Duration: 3-4hr.
Indications: Diabetes Mellitus
Norm. Dosage, Freq, Route, Range: SQ 5-10 units 0-15min before meals (dose
adjustments based on
blood glucose determinations)
Side Effects: hypoglycemia, hypokalemia, injection site reaction
Nursing Considerations: monitor for S&S of hypoglycemia, lab tests: periodically
monitor fasting and
postprandial blood glucose and HbA1C
1.133. Metformin
(Glucophage)
Class: Antidiabetic; Biguanide
Actions: Effective in lowering serum glucose level and ultimately, the HbA1C valve.
Peak: 1-3hr. Half-life:
6.2-17.6hr.
Indications: treatment of type 2 diabetes mellitus as adjunct to diet and exercise
Norm. Dosage, Freq, Route, Range: PO start w/ 500mg daily tid or 850mg daily bid w/
meals, may
increase by 500-850mg/day q1-3wk Max: 2550mg/day
Side Effects: nausea, vomiting, abdominal pain, diarrhea, bitter or metallic taste,
bloatedness, anorexia
Nursing Considerations: Monitor vital signs and fasting and postprandial blood
glucose valves, monitor
cardiopulmonary status, Lab tests: baseline and periodic LFTs, kidney function
tests, hematologic
parameters for anemia, periodic fasting blood glucose, and HbA1C q3months.

Page 59 of 75
Drug Med Cards
35. Antihypoglycemic
1.134. Glucagon
(Glucagen)
Class: Antihypoglycemic
Actions: increases blood glucose secondary to gluconeogenesis, which is the
breakdown of glycogen in
the liver. Onset: 5-20 min. Peak: 30 min. Duration: 1-1.5hr. Half-life: 3-10 min.
Indications: hypoglycemia, radiologic studies of GI Tract
Norm. Dosage, Freq, Route, Range: IM/IV/SQ 1mg may repeat q5-20min if no response
for 1-2more
doses
Side Effects: nausea, vomiting, Stevens-Johnson syndrome
Nursing Considerations: be prepared to give IV glucose if patient fails to respond
to glucagon

Drug Med Cards
36. Anti-fungal
1.135. Metronidazole
(Flagyl)
Class: Antitrichomonal; Amebicide
Actions: Has direct trichomonacidal and amebicial activity; exhibits antibacterial
activity against obligate
anaerobic bacilli, and Clostridia. Peak: 1-3 hr.
Indications: Trichomoniasis, Giardiasis, Amebiasis, Pseudomembranous Colitis,
Rosacea
Norm. Dosage, Freq, Route, Range: PO 7.5 mg/kg q6hr. IV Loading Dose 1.5 mg/kg IV
Maintenance
Dose 7.5 mg/kg q6hr. Max: 4 g/day
Side Effects: Candida, Nausea
Nursing Considerations: Discontinue therapy immediately if symptoms of CNS toxicity
develop, Monitor
for seizures and peripheral neuropathy, Lab tests: obtain total and differential
WBC count before, during,
and after therapy, monitor S&S of sodium retention, monitor patients on lithium,
report appearance of
candidiasis, repeat feces exam, usually up to 3 months to ensure that amebae have
been eliminated.
1.136. Ticonozole
(Monistat Cream)
Class: Anti-fungal
Actions: spectrum antifungal that inhibits the growth of yeast (Candida Albacans)
Indications: Vulvovaginal candidiasis
Norm. Dosage, Freq, Route, Range: 6.5% vaginal ointment, intra vaginal x1day (one
full applicator at
bed time)
Side Effects: mild erythema, burning, discomfort, rash, and itching
Nursing Considerations: monitor for sensitization, and allergic response.

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Drug Med Cards
37. Eye Drops

1.137. Brimonidine Tartrate
(Alphagan P)
Class: Carbonic Anhydrase Inhibitor; Sulfonamide
Actions: to reduce IOP and to protect the lens during surgery and laser iridotomy;
to counteract effects of
mydriatics and cycloplegics following surgery or, ophthalmoscopic exam
Indications: Intraoperative and postsurgical increase in IOP, Open-Angle Glaucoma,
Glaucoma
Norm. Dosage, Freq, Route, Range: 1-2 drops per eye/day
Side Effects: diminished vision in poorly illuminated areas, headache, drowsiness
Nursing Considerations: Do not use in patients with Sulfa allergies
1.138. Timolol Maleate

(Timoptic GTTS)
Class: Beta-Adrenergic Antagonist, eye prep, miotic, antihypertensive, antuanginal
Actions: GTTS: lowers elevated and normal IOP by reducing formation of aqueous
humor/may increase
out flow. Peak: PO 1-2hr. Topical: 1-5hrs.
Indications: Chronic, open angle glaucoma, sec. glaucoma, or ocular hypertension
Norm. Dosage, Freq, Route, Range: 0.25%, 0.5% one drop bid
Side Effects: eye irritant, conjunctivitis, blepharitis, keratitis, superficial
punctuate
Nursing Considerations: √ pulse before administering oral or topical,
√ BP for any extreme rates or
rhythm

Drug Med Cards
38. Antidepressant
1.139. Bupropion HCL
(Wellbutrin, Zyban, Aplenzin, Budeprion)
Class: Antidepressant
Actions: The neurochemical mechanisms of bupropion is not fully understood. It
selectively inhibits the
neuronal reuptake of dopamine. Onset: 3-4wks. Peak: 1-3hrs.
Indications: Depression/Seasonal Affective Disorder
Norm. Dosage, Freq, Route, Range: PO 100mg tid (immediate release) or 150mg bid
(SR), or 300mg
daily (XL), doses greater than 450mg/day are associated w/ an increased risk of
adverse reactions including
seizures Max: 300mg/day
Side Effects: agitation, insomnia, dry mouth, blurred vision, headache, dizziness,
tremor, nausea,
vomiting, constipation.
Nursing Considerations: Lab tests: periodic renal function tests and LFTs; monitor
for and report
delusions, hallucinations, psychotic, episodes, confusion, and paranoia; report
significant restlessness,
agitation, anxiety, and insomnia; monitor weight weekly; report promptly suicidal
thoughts; do not take any
OTC drugs w/o consulting physician.
1.140. Desvenlafaxine
(Pristiq)
Class: Antidepressant; Serotonin Norepinephrine Reuptake Inhibitor (SNRI)
Actions: Potent inhibitor of neuronal serotonin and norepinephrine reuptake. Onset:
2wks. Peak: 1-2hrs.
Duration: extensively tissue bound
Indications: Depression; Anxiety
Side Effects: increased BP & HR, dizziness, somnolence, suicidality, nausea,
vomiting, dry mouth,
sweating
Nursing Considerations: Monitor for worsening of depression or emergence of
suicidal ideation; monitor
cardiovascular status periodically w/ measurements of BP & HR; Lab tests: periodic
lipid profile; monitor
neurologic status and report excessive anxiety, nervousness, and insomnia; monitor
weight periodically
and report excess weight loss; avoid using alcohol
1.141. Duloxetine
(Cymbalta)
Class: Antidepressant; Selective Serotonin Norepinephrine Reuptake Inhibitor
(SSNRI)
Actions: Causes potentiation of serotonergic and noradrenergic activity in the CNS.
Antidepressant and
antianxiety effects are presumed to be due to its dual inhibition of CNS
presynaptic neuronal uptake of
serotonin and norepinephrine, this increasing the serum levels of bith substances.
Peak: 6hrs.
Indications: Depression; Generalized Anxiety/Diabetic Neuropathy/Musculoskeletal
Pain; Fibromyalgia
Norm. Dosage, Freq, Route, Range: PO 40-60mg/day in 1-2 divided doses
Side Effects: insomnia, dry mouth, constipation
Nursing Considerations: Monitor for S&S of numerous drug-drug interactions; Lab
tests: LFTs for
unexplained abdominal pain or enlarged liver; monitor closely for and report
suicidal ideation; report
emergence of any of the following: anxiety, insomnia, agitation, panic attacks,
irritability, hostility,
psychomotor restlessness, hypomania, and mania

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Drug Med Cards
1.142. Mirtazapine
(Remeron)
Class: Tetracyclic Antidepressant; Anxiolytic
Actions: Acts as antidepressant. Effectiveness is indicated by mood elevation.
Peak: 2 hr.
Indications: Depression
Norm. Dosage, Freq, Route, Range: PO 15mg/day in a single dose at bedtime, may
increase Q1-2week
Max: 45mg/day
Side Effects: Somnolence, increased appetite, constipation, dry mouth
Nursing Considerations: Lab tests: monitor WBC count w/ differential, lipid
profile, and ALT/AST
periodically, monitor for worsening of depression or suicidal ideation, asses for
weight gain and excessive
somnolence or dizziness, monitor for orthostatic hypotension w/ a Hx of
cardiovascular disease or
cerebrovascular disease.
1.143. Trazadone
(Desyrel, Oleptro)
Class: Antidepressant
Actions: Centrally acting antidepressant that potentiates serotonin effects by
selectively blocking its
reuptake at presynaptic membranes in CNS. Onset: 1-2wks. Peak: 1-2hrs.
Norm. Dosage, Freq, Route, Range: PO 150mg/day in divided doses, may increase by
50mg/day q3-
4days Max: 400-600mg/day (Immediate release) PO 150mg/day may increase by 75mg/day
at 3 day
intervals Max: 375mg/day (Extended release)
Side Effects: drowsiness, hypotension (including orthostatic hypotension), dry
mouth
Nursing Considerations: Monitor BP & HR & rhythm; monitor for orthostatic
hypotension; be aware that
overdose is characterized by an extension of common adverse effects: vomiting,
lethargy, drowsiness, and
exaggerated anticholinergic effects.
1.144. Venlafaxine
(Effexor)
Class: Antidepressant; Serotonin Norepinephrine Reuptake Inhibitor (SNRI)
Actions: Potent inhibitor of neuronal serotonin and norepinephrine reuptake. Onset:
2wks. Peak: 1-2hrs.
Duration: extensively tissue bound
Indications: Depression; Anxiety
Side Effects: increased BP & HR, dizziness, somnolence, suicidality, nausea,
vomiting, dry mouth,
sweating
Nursing Considerations: Monitor for worsening of depression or emergence of
cardiovascular status periodically w/ measurements of BP & HR; Lab tests: periodic
lipid profile; monitor
neurologic status and report excessive anxiety, nervousness, and insomnia; monitor
weight periodically
and report excess weight loss; avoid using alcohol
Drug Med Cards
39. Tricyclic Antidepressants

1.145. Amitriptyline HCL
(Elavil)
Class: Tricyclic Antidepressant
Actions: a tricyclic antidepressant that inhibits the reuptake of serotonin (5-HT)
and norepinephrine from
the synaptic gap; also inhibits norepinephrine reuptake to a moderate degree. Peak:
2-12hrs.
Indications: Antidepressant
Norm. Dosage, Freq, Route, Range:
Side Effects: drowsiness, sedation, dizziness, orthostatic hypotension, dry mouth,
constipation, urinary
retention, bone marrow suppression
Nursing Considerations: Lab tests: baseline and periodic leukocyte and differential
counts, renal and
hepatic function tests, monitor BP and pulse rate, monitor I&O and bowel
elimination pattern
1.146. Doxepin HCL

(Sinequan, Prudoxin, Silenor, Zonalon)
Class: Tricyclic Antidepressants; Anxiolytic
Actions: inhibits serotonin reuptake from the synaptic gap; also inhibits
norepinephrine reuptake to a
moderate degree. Peak: 2hrs.
Indications: Depression/Anxiety; Insomnia (Silenor), Dermatitis
Norm. Dosage, Freq, Route, Range: PO 25-150mg/day in divided doses, may increase up
to 300mg/day
Max: 300mg/day
Side Effects: drowsiness, orthostatic hypotension, dry mouth, blurring or stinging
at application site
Nursing Considerations: monitor use of other CNS depressants, including alcohol; be
alert to changes
in voiding and evaluate pt. for constipation and abdominal distention; maintain
established dosage regimen
and avoid change of intervals, doubling, reducing, or skipping doses.
1.147. Imipramine HCL

(Tofranil)
Class: Tricyclic Antidepressant (TCA)
Actions: TCAs potentiate both norepinephrine and serotonin in the CNS by blocking
their reuptake. Peak:
1-2hr.
Indications: Depression; enuresis
Norm. Dosage, Freq, Route, Range: PO 75-100mg/day Max: 300mg/day in 1 or more
divided doses.
Side Effects: sedation, drowsiness, angioedema, orthostatic hypotension,
arrhythmias, MI, heart block,
blurred vision, slight mydriasis, dry mouth, urinary retention, agranulocytosis,
thrombocytopenia
Nursing Considerations: Lab tests: monitor periodic LFTs, renal function, CBC w/
diff, and fluid and
electrolyte balance, monitor HR and BP frequently, report EPS, Avoid exposure to
sunlight and use
sunscreen
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Drug Med Cards
1.148. Nortriptyline HCL

(Aventyl, Pamelor)
Class: Tricyclic Antidepressant
Actions: Secondary amine derivative of amitriptyline that inhibits that action of
many chemical agents
including catecholamines. Mood elevation may be due to its inhibition of reuptake
of serotonin or another
neurotransmitter at the presynaptic membrane. Peak: 7-8.5hrs. Duration: Crosses
placenta; distributed in
breast milk
Indications: Antidepressant; Nocturnal Enuresis
Norm. Dosage, Freq, Route, Range: PO 25mg tid or qid, gradually increase to 100-
150mg/day
Side Effects: orthostatic hypotension, dry mouth, agranulocytosis, urinary
retention
Nursing Considerations: monitor BP & pulse rate during adjustment period, if
systolic BP fall more than
20mm Hg or if there is a sudden increase in pulse rate, w/hold medication and
notify prescriber; inspect
oral membranes daily; monitor bowel elimination pattern and I&O ratio; do not use
OTC drugs unless your
prescriber approves

Drug Med Cards
40. Selective Serotonin Reuptake Inhibitor (SSRI)

1.149. Citalopram Hydrobromide
(Celexa)
Class: Selective Serotonin Reuptake Inhibitor (SSRI)
Actions: SSRI w/ an antidepressant effect presumed to be linked to its inhibition
of CNS presynaptic
neuronal uptake of serotonin. Peak: steady-state serum concentrations in 1wk; peak
blood levels at 4hrs.
Norm. Dosage, Freq, Route, Range: PO start at 20mg/day, may increase to 40mg/day if
needed
Side Effects: nausea, dry mouth, insomnia, somnolence
Nursing Considerations: watch closely for worsening of depression or emergence of
suicidal ideations;
Lab tests: monitor periodically hepatic function, CBC, serum sodium, and lithium
levels when the two drugs
are given concurrently; monitor periodically HR & BP, and carefully monitor
complete cardiac status in
person w/ known or cardiac disease; avoid alcohol
1.150. Escitalopram Oxalate

(Lexapro)
Class: Antidepressant; Selective Serotonin Reuptake Inhibitor (SSRI)
Actions: antidepressant effect is presumed to be linked to its inhibition of CNS
presynaptic neuronal
uptake of serotonin. Onset: Approximately 1 wk. Peak: 3hr Half-life: 25hr
Indications: depression, generalized anxiety disorder
Norm. Dosage, Freq, Route, Range: PO 10mg daily, may increase to 20mg daily if
needed after 1 wk
Max: 20mg/day
Side Effects: nausea, insomnia, somnolence, decreased libido
Nursing Considerations: closely observe for worsening of depression or suicide, Lab
tests: monitor
periodically LFTs, serum sodium, and lithium levels, monitor periodically HR and BP
and carefully monitor
complete cardiac status
1.151. Fluoxetine HCL

(Prozac)
Class: Selective Serotonin Reuptake Inhibitor (SSRI), Antidepressant
Actions: antidepressant effect is presumed to be linked to inhibition of CNS
neuronal uptake of serotonin
Indications: depression, gastric depression, OCD, bulimia, premenstrual dysphoric
disorder, panic
disorder
Norm. Dosage, Freq, Route, Range: PO 20mg/day in AM, may increase by 20mg/day at
weekly intervals
Max: 80mg/day
Side Effects: headache, nervousness, anxiety, insomnia, nausea, diarrhea
Nursing Considerations: Monitor renal and hepatic functions. Supervise patients
closely who are high
suicide risks. Lab tests: periodic serum electrolytes, monitor closely plasma
glucose in diabetes.
Page 67 of 75
Drug Med Cards
1.152. Paroxetine
(Paxil, Pexeva)
Actions: It is highly potent and a highly selective inhibitor of serotonin reuptake
by neurons in CNS. Onset:
2wks. Peak: 5-8hrs.
Indications: Depression; OCD; Panic Attacks; Social Anxiety; Generalized Anxiety,
PTSD; Premenstrual
Dysphoric Disorder
Norm. Dosage, Freq, Route, Range: PO 10-50mg/day Max: 80mg/day
Side Effects: Headache, sedation, nausea, dry mouth
Nursing Considerations: monitor for worsening of depression or emergence of
for significant weight loss; monitor pt. w/ history of mania for reactivation of
condition; monitor pts. w/
preexisting cardiovascular disease carefully because paroxetine may adversely
affect hemodynamics
status
1.153. Sertraline HCL

(Zoloft)
Actions: Effective in controlling depression, obsessive-compulsive disorder,
anxiety, and panic disorder.
Onset: 2-4 weeks
Indications: Depression, Anxiety, Obsessive-Compulsive Disorder
Norm. Dosage, Freq, Route, Range: begin w/ 50mg/day, gradually increase every few
weeks according
to response Max: 200mg/day
Side Effects: agitation, insomnia, headache, dizziness, somnolence, fatigue
Nursing Considerations: supervise patients at risk for suicide closely, monitor for
worsening of
depression or emergence of suicidal ideation, monitor older adults for fluid and
sodium imbalances, monitor
patients w/ a Hx of a seizure disorder closely, lab tests: monitor PT /INR w/
patients receiving concurrent
warfarin therapy
1.154. Vilazodone
(Vibryd)
Class: Selective Serotonin Reuptake Inhibitor (SSRI); Psychotherapeutic Agent;
Antidepressant
Actions: Antidepressant is presumed to be linked to inhibition of CNS neuronal
uptake of the
neurotransmitter, serotonin. Peak: 4-5hrs.
Indications: Major Depressive Disorder
Norm. Dosage, Freq, Route, Range: PO initial dose of 10mg/day for 7 days, increase
to 20mg/day for 7
days, then to 40mg/day
Side Effects: dizziness, diarrhea, nausea
Nursing Considerations: monitor for worsening of depression or emergence of
suicidal ideation; supervise
pts. Closely who are high suicide risks; do not stop medication abruptly
Drug Med Cards
41. Monoamine Oxidase Inhibitors (MAOIs)

1.155. Isocarboxazid
(Marplan)
Class: Antidepressant; MAOI
Actions: Inhibits monoamine oxidase, the enzyme involved in the catabolism of
catecholamine
neurotransmitters and serotonin. Duration: up to 2wks.
Indications: Refractory Depression
Norm. Dosage, Freq, Route, Range: PO 10-30mg/day in 1-3 divided doses Max: 30mg/day
Side Effects: drowsiness, overactivity, insomnia, orthostatic hypotension,
paradoxical hypertension,
blurred vision, nausea, constipation, anorexia, urinary retention, dry mouth
Nursing Considerations: Monitor BP for orthostatic hypotension, monitor for
therapeutic effectiveness,
monitor and report promptly signs of clinical deterioration or suicidal ideation,
check for peripheral edema
daily and monitor weight several times weekly and monitor weight several times
weekly, toxic symptoms
from over-dosage or from substances or from ingestion of contraindicated substances
(e.g., foods high in
tyramine) may occur w/in hours
1.156. Phenelzine Sulfate

(Nardil)
Actions: potent hydrazine MAOI. Antidepressant action believed to be due to
irreversible inhibition of
MAOI, thereby permitting increased conxentrations of endogenous epinephrine,
norepinephrine, serotonin,
and dopamine w/in presynaptic neurons and at receptor sites. Onset: 2 weeks
Norm. Dosage, Freq, Route, Range: PO 1.5mg tid, rapidly increase to at least
60mg/day, may need up
to 90mg/day Max: 90mg/day
Side Effects: orthostatic hypotension, insomnia, respiratory depression, coma,
hypertensive crisis,
circulatory collapse, constipation, dry mouth, nausea, vomiting, anorexia,
leukopenia
Nursing Considerations: Monitor BP and Pulse, Lab tests: baseline and periodic CBC
and LFTs; pts on
prolonged therapy should be checked periodically for altered color perception,
changes in fundi or visual
fields, changes in red-green vision may be the 1st indication of eye damage, strict
thymine diet
1.157. Tranylcypromine Sulfate

(Parnate)
Actions: Potent MAO w/ a antidepressant activity that arises from the increased
availability of monoamines
resulting from the inhibition of the enzyme MAO. This leads to increased
concentration of neurotransmitters,
such as epinephrine, norepinephrine, and dopamine in the CNS. Onset: 10 days
Indications: Severe Depression
Norm. Dosage, Freq, Route, Range: PO 30mg/day in 2 divided doses, may increase by
10mg/day at 2-
3wk intervals Max: 60mg/day
Side Effects: Orthostatic hypotension, hypertensive crisis
Nursing Considerations: monitor BP closely, sever hypertensive reactions are known
to occur with
MAOIs; monitor for changes in behavior; do not eat tyramine-containing foods; be
aware of excessive use
of caffeine-containing beverages; make position changes slowly; avoid alcohol and
other CNS depressants

Page 69 of 75
Drug Med Cards
42. Anti-Emetic
1.158. Ondansetron HCL
(Zofran)
Class: 5-HT3 Anatagonist, Antiemetic
Actions: Prevents nausea and vomiting associated with cancer chemotherapy and
anesthesia. Peak: 1-
1.5hr Half-life: 3hr
Indications: prevention of nausea and vomiting associated with initiation and
repeated courses of cancer
chemotherapy, including high-dose cisplatin; postoperative nausea and vomiting
Norm. Dosage, Freq, Route, Range: PO 8-24mg 30 min before chemotherapy, than q8hr
times 2 more
doses
Side Effects: headache, sedation, diarrhea
Nursing Considerations: monitor fluid and electrolyte status, cardiovascular status

Drug Med Cards
43. Antituberculosis
1.159. Isoniazid
(INH, Laniazid)
Class: Anti-infective; Antituberculosis
Actions: Exerts bacteriostatic action against actively growing tubercle bacilli,
may be bactericidal in higher
concentrations. Peak: 1-2 hr
Indications: Treatment of Active Tuberculosis, preventative therapy
Norm. Dosage, Freq, Route, Range: PO/IM 5mg/kg Max: 300 mg/day
Side Effects: Paresthesias, peripheral neuropathy, hepatotoxicity (elevated AST,
ALT; bilirubinemia;
jaundice; hepatitis)
Nursing Considerations: Monitor for therapeutic effectiveness, w/hold drug and
notify prescriber
immediately of a hypersensitivity reaction, Lab tests: monitor LFTs periodically,
monitor for and report signs
of hepatotoxicity, monitor BP, check weight at least twice weekly under standard
conditions

Page 71 of 75
Drug Med Cards
44. Substance Abuse Deterrent

1.160. Acamprosate Calcium
(Campral)
Class: Substance Abuse Deterrent
Actions: Reduces craving for alcohol intake due to chronic use, but does not cause
alcohol aversion or a
disulfiram-like reaction as a result of alcohol ingestion. Half-life: 20-33hr.
Indications: Maintenance of Alcohol Abstinence
Norm. Dosage, Freq, Route, Range: PO 666mg tid
Side Effects: diarrhea, flatulence
Nursing Considerations: Monitor S&S of depression or suicidal thinking; monitor
or impaired judgment or thinking, dizziness or impaired motor skills; report
promptly unusual anxiousness
or nervousness, depression or suicidal thoughts, burning or tingling sensations in
arms, legs, hands or feet,
chest pains or palpitations, or difficulty urinating; report any alcohol
consumption during therapy.
1.161. Antabuse
Class: Enzyme Inhibitor; Anti-Alcoholic Agent
Actions: Acts as a deterrent to alcohol ingestion by inhibiting the enzyme
acetaldehyde dehydrogenase,
which normally metabolizes alcohol in the body. Onset: Up to 12hr. Duration: Up to
2wk. Onset: Up to 12hr.
Duration: Up to 2wk.
Indications: Alcoholism
Norm. Dosage, Freq, Route, Range: PO 500mg/day for 1-2wk, then 125-500mg/day Max:
500mg/day
Side Effects: marked respiratory depression, unconsciousness, convulsions, sudden
death, hepatotoxicity
Nursing Considerations: Lab tests: baseline & follow-up transaminase studies every
10-14 days to detect
hepatic dysfunction; treat pt. w/ severe disulfiram reaction as though in shock,
monitor potassium levels,
especially if pt. has diabetes mellitus; explain the danger of alcohol ingestion
during treatment to pt.; report
promptly to prescriber the onset of nausea w/ RUQ pain or discomfort, itching,
jaundiced sclera or skin,
dark urine or clay-colored stools, w/hold drug pending LFTs

Drug Med Cards
45. Bone Metabolism Regulatory

1.162. Pamidronate
(Aredia)
Class: Bisphosphonate (Bone Metabolism Regulatory)
Actions: Reduces bone turnover and, when used in combination with adequate
hydration, it increases
renal excretion of calcium, thus reducing serum calcium concentrations. Onset: 24-
48 hr Peak: 6 days
Duration: 2 weeks-3months
Indications: Moderate to severe hypercalcemia of malignancy, Paget’s Diease,
Osteolytic Metastases
Norm. Dosage, Freq, Route, Range: IV 60-90 mg infused over 4-24 hr, may repeat in 7
days
Side Effects: fever w/ or w/o rigors, thrombophlebitis at injection site,
hypocalcemia, epigastric discomfort
Nursing Considerations: Assess IV injection site for thrombophlebitis, Lab tests:
monitor serm calcium,
phosphate, magnesium, and potassium at frequent intervals; CBC with defferential,
Hct and Hgb; and
kidney function tests throughout course of therapy, monitor for S&S of
hypocalcemia, hypokalemia,
hypomagnesemia and hypophosphatemia, monitor for seizures, monitor vital signs

Page 73 of 75
Drug Med Cards
46. Bacterial Collagenase Enzyme

1.163. Collagenase Clostridum Histolyticum
(Xiaflex)
Class: Bacterial Collagenase enzyme
Actions: Collagenases are proteinases that hydrolyze collagen in its native triple
helical conformation
under physiological conditions, resulting in lysis of collagen deposits.
Indications: Dupuytren’s contracture, Peyronie’s Disease
Norm. Dosage, Freq, Route, Range: Topical 1-3x daily to affected areas
Side Effects: mild pain or tenderness in treated hand, cracked skin, under arm pain
Nursing Considerations: call physician if fever, chills, body aches, flu symptoms,
or swollen glands in
your elbow or under arm, watch for bleeding, bruising, swelling, redness, warmth,
numbness, tingling, or
sudden pain or loss of movement

Drug Med Cards
Bibliography
Ebersole, P., Hess, P., Touhy, T.A., Schmidt Logan, A., & Jett, K. (2008) Toward
healthy aging: Human
needs and nursing response ( 7th ed.). St. Louis, MO: Mosby.
Eliopoulous C. (2009). Gerontological nursing. ( 7th ed.). Philadelphia, PA:
Lippincott Williams & Wilkins.
Grodner, M., Long, S., & Walkingshaw,B.C. (2007). Foundations and clinical
application of nutrition: A
nursing approach ( 4th ed.). St. Louis, MO: Mosby.
Ignatavicius, D. D., & Workman, M. L. (2010). Medical-Surgical nursing (6th ed.).
St. Louis, MO:
Saunders.
Lowdermilk, D.L.,& Perry, S.E. ( 2007) . Maternity & women’s health care
(9th ed.). St. Louis, MO: Mosby.
Lehne, R.A. (2010). Pharmacology for nursing care (7th ed.). St. Louis, MO:
Saunders.
Lilley, L. L., Harrington, S., & Snyder, J.S. (2007). Pharmacology and the nursing
process (5th ED.). St.
Louis, MO: Mosby.
Roach, S. S.,& Ford, S. M. (2008). Introductory clinical pharmacology.
Philadelphia, PA: Lippincott
Williams & Wilkins.
Smeltzer, S. C., Bare, B.G., Hinkle, J. L., & Cheever, K.H. ( 2008).
Brunner and Suddarth’s textbook of
medical-surgical nursing ( 11th ed.). Philadelphia, PA: Lippincott Williams &
Wilkins.

Page 75 of 75
Acyclovir
Amantadine HCl
(Zovirax)
(Symmetrel)
Class: Antiviral
Class: Antiviral; Central-Acting Cholinergic Receptor Antagonist; Antiparkinson
Actions: reduces viral shedding and formation of new lesions and speeds healing
Actions: Because Amantadine does not suppress antibody formation, it can be
time. Peak: 1.5-2hr. Half-life: 2.5-5hr.
administered for interim protection in combination w/ influenza. Onset: w/in 48hrs.
Peak: 1-4hrs
Indications: (IV treatment) viral encephalitis, herpes simplex, varicella-zoster
virus
(shingles/chickpox); (orally) herpes simplex, varicella-zoster virus; (topically)
herpes Indications: Influenza A Treatment; Influenza A Preventative;
Parkinsonism; Drug-
labialis (cold sores) and initial episodes of herpes gentitalis
Induced Extrapyramidal Symptoms (EPS)
Norm. Dosage, Freq, Route, Range: PO 400mg bid Max: 800mg/day

Norm. Dosage, Freq, Route, Range: PO 100mg 1-2times/day
Side Effects: headache, nausea, vomiting, diarrhea

Side Effects: dizziness, light-headedness, difficulty in concentrating, insomnia,
leukopenia
Nursing Considerations: Monitor I&O & hydration status. Lab tests: baseline and
periodic renal function tests
Nursing Considerations: Lab tests: pH and serum electrolytes; monitor and report
mental status changes, nervousness, difficulty concentrating, or insomnia, loss of
seizure control, S&S of toxicity, especially in doses over 200mg/day

Alprazolam
Diazepam
(Xanax)
(Diastat, Valium)
Class: Anxiolytic; Sedative-Hypnotic; Benzodiazepine
Class: Benzodiazepine Anticonvulsant; Anxiolytic
Actions: A CNS depressant that appears to act at the limbic, thalamic, and
Actions: Long-acting benzodiazepine psychotherapeutic agent. Benzodiazepines act
hypothalamic levels of the CNS. Has antianxiety and sedative effects w/ addictive
at the limbic. Thalamic, and hypothalamic regions of the CNS and produce CNS
potential. Peak: 1-2 hr. Halh-life: 12-15 hr.
depression resulting in sedation, and anticonvulsant activity dependent on the
dosage. Onset: PO 30-60 min Peak: PO 1-2 hr Duration: IV 15 min-1 hr PO up to 3 hr

Indications: Anxiety Disorders, Panic Attacks
Indications: Status Epilepticus, Muscle Spasm, Anxiety, Alcohol Withdrawal, Pre-op

Norm. Dosage, Freq, Route, Range: PO 0.25-5 mg tid Max: 4 mg/day
Norm. Dosage, Freq, Route, Range: IV/IM 5-10 m, repeat if needed at 10-15 min
Side Effects: Drowsiness, sedation
intervals up to 30 mg, then repeat if needed q2-4hr
Nursing Considerations: Monitor S&S of drowsiness and sedation, especially in

Side Effects: Drowsiness, fatigue, confusion, vivid dreams, headache
older adults or the debilitated, Lab tests: CBC, urinalysis and blood chemistry
studies
particularly during continuing therapy
Nursing Considerations: Monitor for adverse reactions, Monitor for therapeutic
effectiveness-max effect may require 1-2 week, monitor for and report promptly
signs of suicidal ideation especially in those treated for anxiety states

accompanied
by depression, observe patient closely and monitor vital signs when diazepam is
given parentally; hypotension, muscular weakness, tachycardia, and respiratory
depression may occur, Lab tests: periodic CBC and LFTs
Lorazepam
Temazepam
(Ativan)
(Restoril)
Class: Anxioltic; Sedative-Hypnotic; Benzodiazepine
Class: Benzodiazepine, Anxiolytic, Sedative-Hypnotic
Actions: most potent of the available benzodiazepine. Effects (antianxiety,

sedative, Actions: reduces night awakenings and early morning awakenings;
increases total
hypnotic, and skeletal muscle relaxant) are mediated by the inhibition
sleep times, absence of rebound effects. Onset: 30-50 min. Peak: 2-3hr. Duration:
neurotransmitter GABA. Action sites are thalamic, hypothalamic, and limbic levels
of 10-12hr. Half-life: 8-24hr
CNS. Onset: IV 1-5 min. IM 15-30 min. Peak: IM 60-9 min. PO 2 hr Duration 12-24 hr
Indications: to relieve insomnia
Indications: Antianxiety, Insomnia, Premedication, Status Epilepticus
Norm. Dosage, Freq, Route, Range: PO 7.5-30mg at bedtime Max: 30mg/night

Norm. Dosage, Freq, Route, Range: PO 2-6 mg/day in divided doses Max: 10
mg/day
Side Effects: drowsiness, dizziness, lethargy
Side Effects: drowsiness, sedation, dizziness, weakness

Nursing Considerations: hypersensitivity, Lab tests: LFTs and kidney function tests
during long-term use, be aware of S&S of overdose: weakness, confusion, slurred

Nursing Considerations: Supervise ambulation, Lab tests: Assess CBC and LFTs
speech, ataxia, coma w/ reduced or absent reflexes, hypertension and respiratory
periodically
depression

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With over 8 years in the medical field, Mike

"I hope you enjoy the valuable jewels that

Committed to Your Success, Mike

P.S.Feel free to Face book, Twitter, or

HOW THIS WHOLE THING CAME TO BE...

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My Clinial FAILURE form had bold red letters

"NEVER GIVE UP!!" my mom & dad used to tell

What Happened Next Might Surprise you,

The Goal Was To Make A Simple System...

This is where my mentoring for student nurses began.

It was like I had an Ah - HA moment!

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1.2. Amantadine HCl

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1.20. Valproic Acid

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5. Vitamins and Minerals

1.22. Omega-3 Fatty Acids

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1.32. Naltrexone HCL

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10. Analgesic, Antipyretic

1.37. Acetaminophen Suppository

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13. Thyroid Hormone Replacement

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14. Alpha Adronergic Receptor Antagonist

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15. Antiparkinson (Cholinergic Receptor Antagonist

1.46. Ropinirole HCL

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1.47. Trihexyphenidyl HCL

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16. Fluid and Electrolytes

1.49. Dextrose 50%

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1.51. Ferrous Sulfate

1.52. Magnesium Hydroxide

1.53. Potassium Chloride

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Nursing Considerations: √ for allergies to penicillin’s, cephalosporin’s

1.57. Ceftriaxone Sodium

1.58. Clindamycin HCL

1.59. Cortisporin gtts

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1.60. Doxycycline Hyclate

1.61. Gentamicin Ointment

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